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PeerJ. 2017 Feb 23;5:e3046. doi: 10.7717/peerj.3046. eCollection 2017.

Development and validation of a 36-gene sequencing assay for hereditary cancer risk assessment.

Author information

1
Research and Development Department, Counsyl, Inc , South San Francisco , CA , United States.
2
Research and Development Department, Counsyl, Inc, South San Francisco, CA, United States; Current affiliation:  Color Genomics, Inc., Burlingame, CA, United States.
3
Project Management Department, Counsyl, Inc , South San Francisco , CA , United States.
4
Medical Affairs Department, Counsyl, Inc , South San Francisco , CA , United States.
5
Clinical Laboratory, Counsyl, Inc , South San Francisco , California , United States.
6
Research and Development Department, Counsyl, Inc, South San Francisco, CA, United States; Current affiliation:  Freenome, Inc., South San Francisco, CA, United States.

Abstract

The past two decades have brought many important advances in our understanding of the hereditary susceptibility to cancer. Numerous studies have provided convincing evidence that identification of germline mutations associated with hereditary cancer syndromes can lead to reductions in morbidity and mortality through targeted risk management options. Additionally, advances in gene sequencing technology now permit the development of multigene hereditary cancer testing panels. Here, we describe the 2016 revision of the Counsyl Inherited Cancer Screen for detecting single-nucleotide variants (SNVs), short insertions and deletions (indels), and copy number variants (CNVs) in 36 genes associated with an elevated risk for breast, ovarian, colorectal, gastric, endometrial, pancreatic, thyroid, prostate, melanoma, and neuroendocrine cancers. To determine test accuracy and reproducibility, we performed a rigorous analytical validation across 341 samples, including 118 cell lines and 223 patient samples. The screen achieved 100% test sensitivity across different mutation types, with high specificity and 100% concordance with conventional Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA). We also demonstrated the screen's high intra-run and inter-run reproducibility and robust performance on blood and saliva specimens. Furthermore, we showed that pathogenic Alu element insertions can be accurately detected by our test. Overall, the validation in our clinical laboratory demonstrated the analytical performance required for collecting and reporting genetic information related to risk of developing hereditary cancers.

KEYWORDS:

Analytical validation; Hereditary cancer; Multigene panel testing; Next generation sequencing

Conflict of interest statement

All authors, except Alex D. Robertson and Imran S. Haque, are current employees of Counsyl, Inc. Alex is a former employee of Counsyl and is currently employed by Color Genomics, Inc. Imran is also a former employee of Counsyl and is currently employed by Freenome, Inc.

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