Multimodal cell-free DNA whole-genome TAPS is sensitive and reveals specific cancer signals.

Vavoulis DV., Cutts A., Thota N., Brown J., Sugar R., Rueda A., Ardalan A., Howard K., Matos Santo F., Sannasiddappa T., Miller B., Ash S., Liu Y., Song C-X., Nicholson BD., Dreau H., Tregidgo C., Schuh A.

The analysis of circulating tumour DNA (ctDNA) through minimally invasive liquid biopsies is promising for early multi-cancer detection and monitoring minimal residual disease. Most existing methods focus on targeted deep sequencing, but few integrate multiple data modalities. Here, we develop a methodology for ctDNA detection using deep (80x) whole-genome TET-Assisted Pyridine Borane Sequencing (TAPS), a less destructive approach than bisulphite sequencing, which permits the simultaneous analysis of genomic and methylomic data. We conduct a diagnostic accuracy study across multiple cancer types in symptomatic patients, achieving 94.9% sensitivity and 88.8% specificity. Matched tumour biopsies are used for validation, not for guiding the analysis, imitating an early detection scenario. Furthermore, in silico validation demonstrates strong discrimination (86% AUC) at ctDNA fractions as low as 0.7%. Additionally, we successfully track tumour burden and ctDNA shedding from precancerous lesions post-treatment without requiring matched tumour biopsies. This pipeline is ready for further clinical evaluation to extend cancer screening and improve patient triage and monitoring.

DOI

10.1038/s41467-024-55428-y

Type

Journal article

Journal

Nat Commun

Publication Date

08/01/2025

Volume

16

Keywords

Humans, Circulating Tumor DNA, Neoplasms, Liquid Biopsy, High-Throughput Nucleotide Sequencing, Female, Genome, Human, Biomarkers, Tumor, Male, Sensitivity and Specificity, Whole Genome Sequencing, Middle Aged, Early Detection of Cancer, Cell-Free Nucleic Acids

Permalink Original publication