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Clinical cancer research : an official journal of the American Association for Cancer Research · 2024

Early Detection of Malignant and Premalignant Peripheral Nerve Tumors Using Cell-Free DNA Fragmentomics.

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Sundby R Taylor, Szymanski Jeffrey J, Pan Alexander C, Jones Paul A, Mahmood Sana Z, Reid Olivia H, Srihari Divya, Armstrong Amy E, Chamberlain Stacey, Burgic Sanita, Weekley Kara, Murray Béga, Patel Sneh, Qaium Faridi, Lucas Andrea N, Fagan Margaret, Dufek Anne, Meyer Christian F, Collins Natalie B, Pratilas Christine A, Dombi Eva, Gross Andrea M, Kim AeRang, Chrisinger John S A, Dehner Carina A, Widemann Brigitte C, Hirbe Angela C, Chaudhuri Aadel A, Shern Jack F

Аннотация

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.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты