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      Determining lower limits of detection of digital PCR assays for cancer-related gene mutations

      research-article
      1 , * , 1 , , , , ,
      Biomolecular Detection and Quantification
      Elsevier
      PCR, Polymerase Chain Reaction, EGFR, epidermal growth factor receptor, LoB, limit of blank, LoD, limit of detection, N, total number of droplet events counted, NWT, number of droplets with only wild-type DNA, NMut, number of droplets with only mutated DNA, λ, average number of targets “loaded” per droplet, p, fraction of PCR-positive droplets, R, ratio of mutant to wild-type molecules, ΛFP, average number of false-positive events, RFP, average false positive rate (ΛFP/#WT), Digital PCR, Mutation detection, Limit of detection, Assay sensitivity, EGFR L858R, EGFR T790M

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          Highlights

          • Digital PCR offers very high assay sensitivity and limit of detection.

          • An approach for calculating limit of detection is demonstrated for two EGFR assays.

          • Assay LoDs have been evaluated for eighteen cancer targets.

          Abstract

          Digital PCR offers very high sensitivity compared to many other technologies for processing molecular detection assays. Herein, a process is outlined for determining the lower limit of detection (LoD) of two droplet-based digital PCR assays for point mutations of the epidermal growth factor receptor ( EGFR) gene. Hydrolysis probe mutation-detection assays for EGFR p.L858R and p.T790M mutations were characterized in detail. Furthermore, sixteen additional cancer-related mutation assays were explored by the same approach. For the EGFR L8585R assay, the assay sensitivity is extremely good, and thus, the LoD is limited by the amount of amplifiable DNA that is analyzed. With 95% confidence limits, the LoD is one mutant in 180,000 wild-type molecules for the evaluation of 3.3 μg of genomic DNA, and detection of one mutant molecule in over 4 million wild-type molecules was achieved when 70 million copies of DNA were processed. The measured false-positive rate for the EGFR L8585R assay is one in 14 million, which indicates the theoretical LoD if an unlimited amount of DNA is evaluated. For the EFGR T790M assay, the LoD is one mutant in 13,000 for analysis of a 3.3 μg sample of genomic DNA, and the dPCR assay limit sensitivity approaches one mutant in 22,000 wild-type molecules.

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          Most cited references13

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          Limit of blank, limit of detection and limit of quantitation.

          * Limit of Blank (LoB), Limit of Detection (LoD), and Limit of Quantitation (LoQ) are terms used to describe the smallest concentration of a measurand that can be reliably measured by an analytical procedure. * LoB is the highest apparent analyte concentration expected to be found when replicates of a blank sample containing no analyte are tested. LoB = mean(blank) + 1.645(SD(blank)). * LoD is the lowest analyte concentration likely to be reliably distinguished from the LoB and at which detection is feasible. LoD is determined by utilising both the measured LoB and test replicates of a sample known to contain a low concentration of analyte. * LoD = LoB + 1.645(SD (low concentration sample)). * LoQ is the lowest concentration at which the analyte can not only be reliably detected but at which some predefined goals for bias and imprecision are met. The LoQ may be equivalent to the LoD or it could be at a much higher concentration.
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            Multiplex picodroplet digital PCR to detect KRAS mutations in circulating DNA from the plasma of colorectal cancer patients.

            Multiplex digital PCR (dPCR) enables noninvasive and sensitive detection of circulating tumor DNA with performance unachievable by current molecular-detection approaches. Furthermore, picodroplet dPCR facilitates simultaneous screening for multiple mutations from the same sample. We investigated the utility of multiplex dPCR to screen for the 7 most common mutations in codons 12 and 13 of the KRAS (Kirsten rat sarcoma viral oncogene homolog) oncogene from plasma samples of patients with metastatic colorectal cancer. Fifty plasma samples were tested from patients for whom the primary tumor biopsy tissue DNA had been characterized by quantitative PCR. Tumor characterization revealed that 19 patient tumors had KRAS mutations. Multiplex dPCR analysis of the plasma DNA prepared from these samples identified 14 samples that matched the mutation identified in the tumor, 1 sample contained a different KRAS mutation, and 4 samples had no detectable mutation. Among the tumor samples that were wild type for KRAS, 2 KRAS mutations were identified in the corresponding plasma samples. Duplex dPCR (i.e., wild-type and single-mutation assay) was also used to analyze plasma samples from patients with KRAS-mutated tumors and 5 samples expected to contain the BRAF (v-raf murine sarcoma viral oncogene homolog B) V600E mutation. The results for the duplex analysis matched those for the multiplex analysis for KRAS-mutated samples and, owing to its higher sensitivity, enabled detection of 2 additional samples with low levels of KRAS-mutated DNA. All 5 samples with BRAF mutations were detected. This work demonstrates the clinical utility of multiplex dPCR to screen for multiple mutations simultaneously with a sensitivity sufficient to detect mutations in circulating DNA obtained by noninvasive blood collection.
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              BEAMing and Droplet Digital PCR Analysis of Mutant IDH1 mRNA in Glioma Patient Serum and Cerebrospinal Fluid Extracellular Vesicles

              Development of biofluid-based molecular diagnostic tests for cancer is an important step towards tumor characterization and real-time monitoring in a minimally invasive fashion. Extracellular vesicles (EVs) are released from tumor cells into body fluids and can provide a powerful platform for tumor biomarkers because they carry tumor proteins and nucleic acids. Detecting rare point mutations in the background of wild-type sequences in biofluids such as blood and cerebrospinal fluid (CSF) remains a major challenge. Techniques such as BEAMing (beads, emulsion, amplification, magnetics) PCR and droplet digital PCR (ddPCR) are substantially more sensitive than many other assays for mutant sequence detection. Here, we describe a novel approach that combines biofluid EV RNA and BEAMing RT-PCR (EV-BEAMing), as well droplet digital PCR to interrogate mutations from glioma tumors. EVs from CSF of patients with glioma were shown to contain mutant IDH1 transcripts, and we were able to reliably detect and quantify mutant and wild-type IDH1 RNA transcripts in CSF of patients with gliomas. EV-BEAMing and EV-ddPCR represent a valuable new strategy for cancer diagnostics, which can be applied to a variety of biofluids and neoplasms.
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                Author and article information

                Contributors
                Journal
                Biomol Detect Quantif
                Biomol Detect Quantif
                Biomolecular Detection and Quantification
                Elsevier
                2214-7535
                20 August 2014
                September 2014
                20 August 2014
                : 1
                : 1
                : 8-22
                Affiliations
                [0005]RainDance Technologies, 749 Middlesex Turnpike, Billerica, MA 01821, USA
                Author notes
                [* ]Corresponding author. Tel.: +1 978 495 3300. milburyc@ 123456raindancetech.com
                [1]

                These two authors contributed equally to the manuscript.

                Article
                S2214-7535(14)00004-7
                10.1016/j.bdq.2014.08.001
                5129438
                27920993
                8aabc8a3-b5cb-4a2e-afa7-80bba0c9714e
                © 2014 Published by Elsevier GmbH.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 13 June 2014
                : 18 July 2014
                : 11 August 2014
                Categories
                Original Article

                pcr, polymerase chain reaction,egfr, epidermal growth factor receptor,lob, limit of blank,lod, limit of detection,n, total number of droplet events counted,nwt, number of droplets with only wild-type dna,nmut, number of droplets with only mutated dna,λ, average number of targets “loaded” per droplet,p, fraction of pcr-positive droplets,r, ratio of mutant to wild-type molecules,λfp, average number of false-positive events,rfp, average false positive rate (λfp/#wt),digital pcr,mutation detection,limit of detection,assay sensitivity,egfr l858r,egfr t790m

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