June 1, 2021  |  

Highly sensitive, non-invasive detection of colorectal cancer mutations using single molecule, third generation sequencing.

Colorectal cancer (CRC) represents one of the most prevalent and lethal malignant neoplasms and every individual of age 50 and above should undergo regular CRC screening. Currently, the most effective procedure to detect adenomas, the precursors to CRC, is colonoscopy, which reduces CRC incidence by 80%. However, it is an invasive approach that is unpleasant for the patient, expensive, and poses some risk of complications such as colon perforation. A non-invasive screening approach with detection rates comparable to those of colonoscopy has not yet been established. The current study applies Pacific Biosciences third generation, single molecule sequencing to the inspection of CRC-driving mutations. Our approach combines the screening power and the extremely high accuracy of circular consensus (CCS) third generation sequencing with the non-invasiveness of using stool DNA to detect CRC-associated mutations present at extremely low frequencies and establishes a foundation for a non-invasive, highly sensitive assay to screen the population for CRC and early stage adenomas. We performed a series of experiments using a pool of fifteen amplicons covering the genes most frequently mutated in CRC (APC, Beta Catenin, KRAS, BRAF, and TP53), ensuring a theoretical screening coverage of over 97% for both CRC and adenomas. The assay was able to detect mutations in DNA isolated from stool samples from patients diagnosed with CRC at frequencies below 0.5 % with no false positives. The mutations were then confirmed by sequencing DNA isolated from the excised tumor samples. Our assay should be sensitive enough to allow the early identification of adenomatous polyps using stool DNA as analyte. In conclusion, we have developed an assay to detect mutations in the genes associated with CRC and adenomas using Pacific Biosciences RS Single Molecule, Real Time Circular Consensus Sequencing (SMRT-CCS). With no systematic bias and a much higher raw base-calling quality (CCS) compared to other sequencing methods, the assay was able to detect mutations in stool DNA at frequencies below 0.5 % with no false positives. This level of sensitivity should be sufficient to allow the detection of most adenomatous polyps using stool DNA as analyte, a feature that would make our approach the first non-invasive assay with a sensitivity comparable to that of colonoscopy and a strong candidate for the non-invasive preventive CRC screening of the general population.


April 21, 2020  |  

Enrichment of oral microbiota in early cystic precursors to invasive pancreatic cancer.

Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cysts that can progress to invasive pancreatic cancer. Associations between oncogenesis and oral microbiome alterations have been reported. This study aims to investigate a potential intracystic pancreatic microbiome in a pancreatic cystic neoplasm (PCN) surgery patient cohort.Paired cyst fluid and plasma were collected at pancreatic surgery from patients with suspected PCN (n=105). Quantitative and qualitative assessment of bacterial DNA by qPCR, PacBio sequencing (n=35), and interleukin (IL)-1ß quantification was performed. The data were correlated to diagnosis, lesion severity and clinical and laboratory profile, including proton-pump inhibitor (PPI) usage and history of invasive endoscopy procedures.Intracystic bacterial 16S DNA copy number and IL-1ß protein quantity were significantly higher in IPMN with high-grade dysplasia and IPMN with cancer compared with non-IPMN PCNs. Despite high interpersonal variation of intracystic microbiota composition, bacterial network and linear discriminant analysis effect size analyses demonstrated co-occurrence and enrichment of oral bacterial taxa including Fusobacterium nucleatum and Granulicatella adiacens in cyst fluid from IPMN with high-grade dysplasia. The elevated intracystic bacterial DNA is associated with, but not limited to, prior exposure to invasive endoscopic procedures, and is independent from use of PPI and antibiotics.Collectively, these findings warrant further investigation into the role of oral bacteria in cystic precursors to pancreatic cancer and have added values on the aetiopathology as well as the management of pancreatic cysts. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


April 21, 2020  |  

Hybrid sequencing-based personal full-length transcriptomic analysis implicates proteostatic stress in metastatic ovarian cancer.

Comprehensive molecular characterization of myriad somatic alterations and aberrant gene expressions at personal level is key to precision cancer therapy, yet limited by current short-read sequencing technology, individualized catalog of complete genomic and transcriptomic features is thus far elusive. Here, we integrated second- and third-generation sequencing platforms to generate a multidimensional dataset on a patient affected by metastatic epithelial ovarian cancer. Whole-genome and hybrid transcriptome dissection captured global genetic and transcriptional variants at previously unparalleled resolution. Particularly, single-molecule mRNA sequencing identified a vast array of unannotated transcripts, novel long noncoding RNAs and gene chimeras, permitting accurate determination of transcription start, splice, polyadenylation and fusion sites. Phylogenetic and enrichment inference of isoform-level measurements implicated early functional divergence and cytosolic proteostatic stress in shaping ovarian tumorigenesis. A complementary imaging-based high-throughput drug screen was performed and subsequently validated, which consistently pinpointed proteasome inhibitors as an effective therapeutic regime by inducing protein aggregates in ovarian cancer cells. Therefore, our study suggests that clinical application of the emerging long-read full-length analysis for improving molecular diagnostics is feasible and informative. An in-depth understanding of the tumor transcriptome complexity allowed by leveraging the hybrid sequencing approach lays the basis to reveal novel and valid therapeutic vulnerabilities in advanced ovarian malignancies.


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