Accurate detection of low prevalence AKT1 E17K mutation in tissue or plasma from advanced cancer patients

PLoS One. 2017 May 4;12(5):e0175779. doi: 10.1371/journal.pone.0175779. eCollection 2017.

Abstract

Personalized healthcare relies on accurate companion diagnostic assays that enable the most appropriate treatment decision for cancer patients. Extensive assay validation prior to use in a clinical setting is essential for providing a reliable test result. This poses a challenge for low prevalence mutations with limited availability of appropriate clinical samples harboring the mutation. To enable prospective screening for the low prevalence AKT1 E17K mutation, we have developed and validated a competitive allele-specific TaqMan® PCR (castPCR™) assay for mutation detection in formalin-fixed paraffin-embedded (FFPE) tumor tissue. Analysis parameters of the castPCR™ assay were established using an FFPE DNA reference standard and its analytical performance was assessed using 338 breast cancer and gynecological cancer FFPE samples. With recent technical advances for minimally invasive mutation detection in circulating tumor DNA (ctDNA), we subsequently also evaluated the OncoBEAM™ assay to enable plasma specimens as additional diagnostic opportunity for AKT1 E17K mutation testing. The analysis performance of the OncoBEAM™ test was evaluated using a novel AKT1 E17K ctDNA reference standard consisting of sheared genomic DNA spiked into human plasma. Both assays are employed at centralized testing laboratories operating according to quality standards for prospective identification of the AKT1 E17K mutation in ER+ breast cancer patients in the context of a clinical trial evaluating the AKT inhibitor AZD5363 in combination with endocrine (fulvestrant) therapy.

Publication types

  • Validation Study

MeSH terms

  • Humans
  • Mutation*
  • Neoplasms / blood
  • Neoplasms / enzymology*
  • Neoplasms / genetics
  • Paraffin Embedding
  • Polymerase Chain Reaction
  • Proto-Oncogene Proteins c-akt / genetics*
  • Reference Standards
  • Reproducibility of Results

Substances

  • AKT1 protein, human
  • Proto-Oncogene Proteins c-akt

Grants and funding

This work was funded by AstraZeneca. AstraZeneca provided support in the form of salaries for authors ECB, JLW, CC, PMK, JCF, JPOL, GS, HJA, AK. Horizon Discovery Ldt provided support in the form of salary for author JA. The specific roles of these authors are articulated in the "Author Contributions" section. AstraZeneca and Horizon Discovery Ldt did not have any role in the study design, data collection or analysis, decision to publish, or preparation of the manuscript.