QPOLE: A Quick, Simple, and Cheap Alternative for POLE Sequencing in Endometrial Cancer by Multiplex Genotyping Quantitative Polymerase Chain Reaction

鈥� An ASCO Reading Room selection

July 19, 2023

Anne Sophie V.M. Van den Heerik, MD; Natalja T. Ter Haar; Lisa Vermij, MD; Jan J. Jobsen, MD, PhD; Mariel Brinkhuis, MD, PhD; Suzan M. Roothaan, MD; Alicia Leon-Castillo, MD, PhD; Gitte Ortoft, MD, PhD; Estrid Hogdall, MD, PhD; Claus Hogdall, MD, PhD; Tom Van Wezel, PhD; Ludy C.H.W. Lutgens, MD, PhD; Marie A.D. Haverkort, MD; Jas Khattra, PhD; Jessica N. McAlpine, MD, PhD; Carien L. Creutzberg, MD, PhD; Vincent T.H.B.M. Smit, MD, PhD; C. Blake Gilks, MD, PhD; Nanda Horeweg, MD, PhD; and Tjalling Bosse, MD, PhD

JCO Global Oncology

This Reading Room is a collaboration between 木瓜直播庐 and:

Below is the abstract of the article.

Read the full article PDF by clicking here

or on the link below.

Purpose

Detection of 11 pathogenic variants in the POLE gene in endometrial cancer (EC) is critically important to identify women with a good prognosis and reduce overtreatment. Currently, POLE status is determined by DNA sequencing, which can be expensive, relatively time-consuming, and unavailable in hospitals without specialized equipment and personnel. This may hamper the implementation of POLE-testing in clinical practice. To overcome this, we developed and validated a rapid, low-cost POLE hotspot test by a quantitative polymerase chain reaction (qPCR) assay, QPOLE.

Materials and Methods

Primer and fluorescence-labeled 5′-nuclease probe sequences of the 11 established pathogenic POLE mutations were designed. Three assays, QPOLE-frequent for the most common mutations and QPOLE-rare-1 and QPOLE-rare-2 for the rare variants, were developed and optimized using DNA extracted from formalin-fixed paraffin-embedded tumor tissues. The simplicity of the design enables POLE status assessment within 4-6 hours after DNA isolation. An interlaboratory external validation study was performed to determine the practical feasibility of this assay.

Results

Cutoffs for POLE wild-type, POLE-mutant, equivocal, and failed results were predefined on the basis of a subset of POLE mutants and POLE wild-types for the internal and external validation. For equivocal cases, additional DNA sequencing is recommended. Performance in 282 EC cases, of which 99 were POLE-mutated, demonstrated an overall accuracy of 98.6% (95% CI 97.2-99.9), a sensitivity of 95.2% (95% CI 90.7-99.8), and a specificity of 100%. After DNA sequencing of 8.8% equivocal cases, the final sensitivity and specificity were 96.0% (95% CI 92.1-99.8) and 100%. External validation confirmed feasibility and accuracy.

Conclusion

QPOLE is a qPCR assay that is a quick, simple, and reliable alternative for DNA sequencing. QPOLE detects all pathogenic variants in the exonuclease domain of the POLE gene. QPOLE will make low-cost POLE-testing available for all women with EC around the globe.

Read an interview about the study here.

Read the full article

QPOLE: A Quick, Simple, and Cheap Alternative for POLE Sequencing in Endometrial Cancer by Multiplex Genotyping Quantitative Polymerase Chain Reaction

Primary Source

JCO Global Oncology

Source Reference:

木瓜直播