1. Early Detection of Malignant and Premalignant Peripheral Nerve Tumors Using Cell-Free DNA Fragmentomics.
- Author
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Sundby RT, Szymanski JJ, Pan AC, Jones PA, Mahmood SZ, Reid OH, Srihari D, Armstrong AE, Chamberlain S, Burgic S, Weekley K, Murray B, Patel S, Qaium F, Lucas AN, Fagan M, Dufek A, Meyer CF, Collins NB, Pratilas CA, Dombi E, Gross AM, Kim A, Chrisinger JSA, Dehner CA, Widemann BC, Hirbe AC, Chaudhuri AA, and Shern JF
- Subjects
- Humans, Female, Male, Adult, Middle Aged, Neurofibromatosis 1 genetics, Neurofibromatosis 1 diagnosis, Precancerous Conditions genetics, Precancerous Conditions diagnosis, Precancerous Conditions blood, Precancerous Conditions pathology, Peripheral Nervous System Neoplasms genetics, Peripheral Nervous System Neoplasms diagnosis, Peripheral Nervous System Neoplasms pathology, Young Adult, Adolescent, Whole Genome Sequencing methods, Aged, Child, Nerve Sheath Neoplasms genetics, Nerve Sheath Neoplasms diagnosis, Nerve Sheath Neoplasms pathology, Nerve Sheath Neoplasms blood, Early Detection of Cancer methods, Cell-Free Nucleic Acids genetics, Cell-Free Nucleic Acids blood, Biomarkers, Tumor genetics, Biomarkers, Tumor blood, DNA Copy Number Variations
- Abstract
Purpose: Early detection of neurofibromatosis type 1 (NF1)-associated peripheral nerve sheath tumors (PNST) informs clinical decision-making, enabling early definitive treatment and potentially averting deadly outcomes. In this study, we describe a cell-free DNA (cfDNA) fragmentomic approach that distinguishes nonmalignant, premalignant, and malignant forms of PNST in the cancer predisposition syndrome, NF1., Experimental Design: cfDNA was isolated from plasma samples of a novel cohort of 101 patients with NF1 and 21 healthy controls and underwent whole-genome sequencing. We investigated diagnosis-specific signatures of copy-number alterations with in silico size selection as well as fragment profiles. Fragmentomics were analyzed using complementary feature types: bin-wise fragment size ratios, end motifs, and fragment non-negative matrix factorization signatures., Results: The novel cohort of patients with NF1 validated that our previous cfDNA copy-number alteration-based approach identifies malignant PNST (MPNST) but cannot distinguish between benign and premalignant states. Fragmentomic methods were able to differentiate premalignant states including atypical neurofibromas (AN). Fragmentomics also adjudicated AN cases suspicious for MPNST, correctly diagnosing samples noninvasively, which could have informed clinical management., Conclusions: Novel cfDNA fragmentomic signatures distinguish AN from benign plexiform neurofibromas and MPNST, enabling more precise clinical diagnosis and management. This study pioneers the early detection of malignant and premalignant PNST in NF1 and provides a blueprint for decentralizing noninvasive cancer surveillance in hereditary cancer predisposition syndromes., (©2024 The Authors; Published by the American Association for Cancer Research.)
- Published
- 2024
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