Hala Boulos, Christine Lo, Wei Zhu, Terri M. Driessen, Jason Yamada-Hanff, Taylor Harding, Ariane Lozac'hmeur, Tiana Pereira, Anne Sonnenschein, Josh Och, Ailin Jin, Nirali Patel, Rick Blidner, Robert Tell, Jonathan Freaney, Nike Beaubier, Brett Mahon
{"title":"Analytical Validation of Next-Generation Sequencing–Based Comprehensive Liquid Biopsy Assay for Therapy Selection","authors":"Hala Boulos, Christine Lo, Wei Zhu, Terri M. Driessen, Jason Yamada-Hanff, Taylor Harding, Ariane Lozac'hmeur, Tiana Pereira, Anne Sonnenschein, Josh Och, Ailin Jin, Nirali Patel, Rick Blidner, Robert Tell, Jonathan Freaney, Nike Beaubier, Brett Mahon","doi":"10.1016/j.jmoldx.2025.02.005","DOIUrl":"10.1016/j.jmoldx.2025.02.005","url":null,"abstract":"<div><div>Liquid biopsies are an increasingly important tool for the real-time monitoring of biomarkers, cancer recurrence, and disease burden in oncology practice. Tempus xF+ is a liquid biopsy assay that detects cell-free DNA in blood samples of patients with advanced solid tumors. The xF+ panel covers 523 genes spanning approximately 1.8 Mb of the human genome and can detect single-nucleotide variants and insertions-deletions in 522 genes. It also detects copy number gains in 7 genes and translocations (gene rearrangements) in 10 genes. Furthermore, the larger panel size allows for the calculation of blood tumor mutational burden. This work highlights the analytical validation performed for the xF+ assay, comparing it with a smaller panel liquid biopsy assay, calculating blood tumor mutational burden, and exploring its potential clinical utility.</div></div>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":"27 5","pages":"Pages 383-394"},"PeriodicalIF":3.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ariadna Lara Gutierrez, Iris Halbwedl, Stefan Sauer, Peter Regitnig, Edgar Petru, Rita Seeböck, Susanne Schubert, Cornelia Peternell, Koppány Bodó, Kurt Prein, Karl Kashofer
{"title":"Robust assessment of HRD genomic instability by OncoScan microarrays.","authors":"Ariadna Lara Gutierrez, Iris Halbwedl, Stefan Sauer, Peter Regitnig, Edgar Petru, Rita Seeböck, Susanne Schubert, Cornelia Peternell, Koppány Bodó, Kurt Prein, Karl Kashofer","doi":"10.1016/j.jmoldx.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.jmoldx.2025.02.011","url":null,"abstract":"<p><p>Genomic instability scars are markers for detecting homologous recombination deficiency status in ovarian cancer patients and predicting the response to PARP inhibitor treatment. Currently, only a few reliable and validated assays are available, with the Myriad myChoice CDx being the most commonly used commercial assay for genomic instability scar score determination; given the need for a more straightforward, accessible, and reliable method for detecting genomic instability scars methods. In this work we describe the feasibility of using the microarray OncoScan CNV assay and open-source software packages to quantify genomic instability scores, and the development of an open-access online platform for genomic instability score calculation. Our laboratory-developed test accurately classified homologous recombination-proficient and recombination-deficient samples based on genomic instability scores derived from the Oncoscan CNV assay. Internally evaluated genomic instability scores demonstrated a 92% overall agreement and a higher sample success rate compared to externally analyzed genomic instability scar scores. The availability of HRD determination has doubled the number of patients eligible for PARP therapy. The assay can be conveniently performed on individual samples, and the open-access online platform facilitates HRD determination without the need for specialized bioinformatics support.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shan Wei, Miriam Temmeh Lattin, Stephanie Morgan, Leah DiBianco, Jocelyn Chen, Stephanie Galloway, Sinem Karipcin, Ronald Wapner, Chaim Landau, Eric J Forman, Wendy K Chung, Zev Williams
{"title":"Development of a Clinically Applicable High-Resolution Assay for Sperm Mosaicism.","authors":"Shan Wei, Miriam Temmeh Lattin, Stephanie Morgan, Leah DiBianco, Jocelyn Chen, Stephanie Galloway, Sinem Karipcin, Ronald Wapner, Chaim Landau, Eric J Forman, Wendy K Chung, Zev Williams","doi":"10.1016/j.jmoldx.2025.03.002","DOIUrl":"10.1016/j.jmoldx.2025.03.002","url":null,"abstract":"<p><p>Sperm mosaicism, the presence of a pathogenic variant in a subset of sperm, is an important cause of heritable genetic disease. However, clinical testing for sperm mosaicism outside research has been limited by the lack of Clinical Laboratory Improvement Amendments (CLIA)-validated results deliverable to patients. We developed the Sensitive Assay for Mosaicism (SAM), a two-phase method for sperm mosaicism detection. In phase 1, sperm DNA undergoes deep sequencing using next-generation sequencing or nanopore-based sequencing with unique molecular identifiers (UMIs) to improve accuracy. In phase 2, PCR primers specific to UMI sequences generate amplicons for CLIA-validated Sanger sequencing, providing patient-ready results. SAM's performance was characterized and tested on semen samples from 14 participants, each with a prior offspring with a de novo pathogenic variant. SAM demonstrated a detection limit of approximately 0.005%. The UMI strategy improved sequencing accuracy on next-generation sequencing and nanopore platforms from 99.9% to >99.999%, and from 93% to >99.99%, respectively. Sperm mosaicism was identified in two tested cases: FAM111A (5.51%) and FGFR3 (0.0129%), with FGFR3 exhibiting selfish mutation validated in unrelated individuals showing varying mosaicism levels. SAM provides sensitive detection of low-level sperm mosaicism with CLIA-validated results for patients, enabling recurrence risk assessment and guiding risk mitigation strategies such as in vitro fertilization with preimplantation genetic testing for monogenic disease, sperm donation, and prenatal diagnosis.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bradley Hall, Sawsan Alyafei, Sathishkumar Ramaswamy, Shruti Sinha, Maha El Naofal, Fatima Rabea, Bryan J Killinger, Gary J Latham, Ahmad Abou Tayoun
{"title":"A Dual-Mode Targeted Nanopore Sequencing Assay for Comprehensive SMN1 and SMN2 Variant Analysis.","authors":"Bradley Hall, Sawsan Alyafei, Sathishkumar Ramaswamy, Shruti Sinha, Maha El Naofal, Fatima Rabea, Bryan J Killinger, Gary J Latham, Ahmad Abou Tayoun","doi":"10.1016/j.jmoldx.2025.03.001","DOIUrl":"10.1016/j.jmoldx.2025.03.001","url":null,"abstract":"<p><p>Spinal muscular atrophy (SMA) is one of the most common recessive disorders. Several life-saving treatment options are available. It is essential to establish universal SMA screening and diagnostic programs using scalable, cost-effective, and accessible platforms to accurately identify all variation types. This identification is complicated by homologous SMN1 and SMN2 genes. Toward this goal, a dual-mode PCR-based target-enrichment method was developed, optimized, and evaluated in an external laboratory as a proof-of-concept for scalable and deployable any-length nanopore sequencing. The assay generates 2.7- to 11.2-kb amplicons spanning exons 3 to 8 of the SMN1 and SMN2 genes, which are then analyzed using a variant calling model that reports sequence and copy number variants specific to each gene from paralog-specific sequences and read-depth data. Overall, the assay detected single-nucleotide variants, insertions/deletions, and copy number variants with >98% genotype agreement across >750 samples, including cell lines, residual presumed-normal whole-blood donors, and patients with known SMN1 and SMN2 genotypes. The assay also demonstrated a dynamic sample throughput, 9-hour turnaround time, and 4-hour hands-on time. Together with the modest capital investment and consumable costs per sample, this assay can help to increase access to SMA testing in low- and middle-income settings. As a result, this PCR/Nanopore sequencing assay and analysis pipeline has the potential for universal implementation in SMA carrier screening and diagnostic programs.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phillip M Galbo, Robert F Klees, Blake Burgher, Kiersten Marie Miles, Carl M Morrison, Sean T Glenn
{"title":"A Comprehensive Guide to Achieving New York State Clinical Laboratory Evaluation Program Approval for Next-Generation Sequencing Assays.","authors":"Phillip M Galbo, Robert F Klees, Blake Burgher, Kiersten Marie Miles, Carl M Morrison, Sean T Glenn","doi":"10.1016/j.jmoldx.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jmoldx.2025.02.009","url":null,"abstract":"<p><p>The FDA's recent move to regulate laboratory-developed tests (LDTs) as in vitro diagnostics (IVDs) has raised significant interest and concerns regarding its implementation. The New York State (NYS) Department of Health's Clinical Laboratory Evaluation Program (CLEP) provides a useful framework for understanding LDT oversight, particularly through its guidelines for next-generation sequencing (NGS) assays. These CLEP requirements for analytical validation are widely recognized as a national standard, yet there is limited peer-reviewed literature detailing the studies needed for CLEP approval. This study presents the validation of the Rapid Pan-Heme (RPPH) assay, a genomic profiling tool for hematopoietic neoplasms, developed in compliance with CLEP standards. The RPPH assay features a comprehensive NGS panel targeting over 400 genes with clinically relevant variants, including single nucleotide variants, insertions and deletions, and fusions critical for classifying hematopoietic malignancies. CLEP approval mandates detailed documentation, quality control metrics, validation studies (accuracy, precision, reproducibility), and compliant clinical reporting. We demonstrate that RPPH achieves CLEP's stringent analytical sensitivity and reproducibility criteria. Variants were orthogonally validated, and proper controls were implemented. Additionally, we outline how RPPH's clinical reports align with CLEP requirements. Overall, this study establishes RPPH as a robust molecular diagnostic tool and provides actionable insights for researchers navigating regulatory compliance and assay validation in clinical settings.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Performance Evaluation of a Next-Generation Sequencing-Based T-Cell Receptor Gene Rearrangement Assay.","authors":"Danica Wiredja, Diane Libert, Diwash Jangam, Chandler Ho, Jack Tung, Bing Melody Zhang","doi":"10.1016/j.jmoldx.2025.02.010","DOIUrl":"10.1016/j.jmoldx.2025.02.010","url":null,"abstract":"<p><p>T-cell receptor (TCR) gene rearrangement clonality studies help resolve atypical T-cell proliferations in the context of suspected malignancy. However, the interpretation criteria for this assay using a next-generation sequencing (NGS) platform have not been extensively explored and standardized. Thus, this project assessed the current performance of the Stanford Health Care in-house NGS-based TCR clonality diagnostic testing with the goal of optimizing the interpretation criteria and identifying recurrent analytical challenges. The current assay identifies a predominant clonotype when its sequence comprises at least 2.5% of the total reads with at least 5× fold change from the background. Using concurrent pathology reports as the clinical truth, this project analyzed 619 cases and determined that the current assay performs at 74% sensitivity and 85% specificity. Receiver operating characteristic analysis identified an optimized interpretation criterion that only improved the diagnostic yield marginally compared with the preexisting algorithm. Further clinicopathologic evaluation of discordant cases revealed that discrepancies mostly arose from technical limitations or the underlying nuanced biology of the diagnosis. Overall, this study provides an objective approach in establishing the interpretation criteria of the current NGS-based TCR clonality test and offers a roadmap for other laboratories considering implementing a similar assay.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Deciphering Genomic Complexity of Multiple Myeloma Using Optimized Optical Genome Mapping","authors":"Hélène Guermouche , Pauline Roynard , Francesca Servoli , Valentin Lestringant , Benoît Quilichini , Christine Terré , Sabine Defasque , Catherine Roche-Lestienne , Dominique Penther , Agnès Daudignon","doi":"10.1016/j.jmoldx.2025.01.003","DOIUrl":"10.1016/j.jmoldx.2025.01.003","url":null,"abstract":"<div><div>The genomic evaluation of multiple myeloma in routine diagnostics involves isolating plasma cells expressing CD138, usually followed by fluorescence <em>in situ</em> hybridization analyses. However, cell sorting often yields a limited number of cells, restricting the number of probes that can be used and limiting the analysis to a few markers required for minimal prognostic classification. Optical genome mapping is a high-resolution technology capable of identifying structural variants and copy number variations across the entire genome; however, it currently requires 1 million cells. To overcome this constraint, an innovative strategy was implemented in this work based on mixing CD138-positive and CD138-negative fractions from the same patient, optimizing the use of available CD138-positive cells for genome-wide analysis. First, dilution experiments demonstrated that a 50% CD138-positive mix was sufficient to achieve complete detection of clonal structural and copy number variants, while establishing a detection threshold of 24% for copy number variants. Using this optimized protocol, 13 additional samples from 13 patients were analyzed. Optical genome mapping achieved 93% (13/15) concordance with fluorescence <em>in situ</em> hybridization for clonal anomalies and revealed >22 additional genomic variations not detected by fluorescence <em>in situ</em> hybridization. This strategy consolidated multiple analyses into a single test, minimized material requirements, and addressed critical prognostic and increasingly described anomalies, providing refined stratification for patients with multiple myeloma.</div></div>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":"27 4","pages":"Pages 306-322"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Careers Can Turn on Tiny Events—Be Prepared for Them","authors":"Daniel H. Farkas","doi":"10.1016/j.jmoldx.2024.10.006","DOIUrl":"10.1016/j.jmoldx.2024.10.006","url":null,"abstract":"","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":"27 4","pages":"Pages 235-236"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eva Chrenková, Radka Spurná, Kateřina Holá, Jana Vrbková, Jana Knillová, Monika Levková, Hana Študentová, Jan Bouchal
{"title":"Platelets, Chromogranin A and C-Reactive Protein Predict Therapy Failure of Metastatic Hormone-Sensitive Prostate Cancer while miR-375 Outperforms Prostate-Specific Antigen in Stratifying Castration-Resistant Prostate Cancer.","authors":"Eva Chrenková, Radka Spurná, Kateřina Holá, Jana Vrbková, Jana Knillová, Monika Levková, Hana Študentová, Jan Bouchal","doi":"10.1016/j.jmoldx.2025.02.006","DOIUrl":"10.1016/j.jmoldx.2025.02.006","url":null,"abstract":"<p><p>Androgen deprivation therapy has long been the first-line treatment for hormone-sensitive prostate cancer (HSPC). After progression to castration-resistant prostate cancer (CRPC), androgen receptor pathway inhibitors (ARPIs) are commonly used. Recently, combined therapy with androgen deprivation and an ARPI has been recommended for metastatic HSPC patients. Novel markers are urgently needed for monitoring this disease and for making therapeutic decisions. Plasma samples were collected from 140 patients with either metastatic HSPC (n = 72) or CRPC (n = 68) before the start of ARPI therapy. Digital PCR was used to assess AR gene amplification, while the expression levels of miR-375 were measured by quantitative PCR. Sixteen other clinical markers were also evaluated, including prostate-specific antigen (PSA), chromogranin A (CGA), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), C-reactive protein (CRP), lymphocyte-to-monocyte ratio, and platelet count. A multivariate analysis, adjusted for age and metastatic dissemination, identified miR-375 expression and lymphocyte-to-monocyte ratio to be the independent negative predictors of ARPI therapy failure in CRPC patients. Regarding the HSPC patients, this article reports the primary finding of the independent negative predictive value of platelet count, CRP, and CGA for the failure of combined androgen deprivation therapy and ARPI.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Scheinfeldt, Dara Kusic, Andrea Gaedigk, Amy J Turner, Ann M Moyer, Victoria M Pratt, Lisa V Kalman
{"title":"New Resources to Identify Characterized DNA Reference Materials for Pharmacogenetic (PGx) and Human Leukocyte Antigen (HLA) Testing: The Genetic Testing Reference Material (GeT-RM) Program PGx Search Tool and GeT-RM Consolidated PGx and HLA Table.","authors":"Laura Scheinfeldt, Dara Kusic, Andrea Gaedigk, Amy J Turner, Ann M Moyer, Victoria M Pratt, Lisa V Kalman","doi":"10.1016/j.jmoldx.2025.02.008","DOIUrl":"10.1016/j.jmoldx.2025.02.008","url":null,"abstract":"<p><p>Regulations, accreditation standards, and professional guidance require laboratories to use reference materials for assay development, validation, quality control, and proficiency testing of clinical genetic tests. There are, however, few publicly available reference materials for most genetic tests. To address this issue, the CDC's Genetic Testing Reference Material Program (GeT-RM), the Coriell Institute for Medical Research, and the genetic testing community have conducted 19 studies, including nine for pharmacogenetic (PGx) and human leukocyte antigen (HLA) testing, to generate characterized, renewable, and publicly available DNA samples for use as reference materials. Because new PGx alleles are frequently identified, and allele designations change over time, many samples were reanalyzed for the same gene(s) in subsequent GeT-RM studies. These studies used more comprehensive and sensitive methods and panels that examined additional single-nucleotide variants and/or star alleles to expand and update the consensus genotypes. Up-to-date information is available in two newly established resources: the GeT-RM Consolidated PGx and HLA Table and the GeT-RM PGx Search Tool. These resources contain all available PGx and HLA genotypes for 363 publicly available samples characterized during nine GeT-RM PGx or HLA studies for 34 genes/loci in a consolidated and searchable format.</p>","PeriodicalId":50128,"journal":{"name":"Journal of Molecular Diagnostics","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}