Validation of BRCA2 mutation scanning using the LightScanner system for high resolution melt analysis Lewis Darnell Nottingham Regional Molecular Genetics Service.

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Transcript Validation of BRCA2 mutation scanning using the LightScanner system for high resolution melt analysis Lewis Darnell Nottingham Regional Molecular Genetics Service.

Slide 1

Validation of BRCA2 mutation scanning
using the LightScanner system for high
resolution melt analysis
Lewis Darnell
Nottingham Regional Molecular Genetics Service


Slide 2

Breast cancer and the BRCA genes
 Breast cancer accounts for 22% of all cancers among women
giving an annual worldwide incidence of approximately
1,000,000 cases.
 5%-10% of breast cancers are hereditary with 30%-50% due
to mutations in either BRCA1 or BRCA2.
 Mutations in BRCA1 or 2 confer a high lifetime risk of both
breast and ovarian cancers.
Gene

Cancer type

Lifetime risk (%)

BRCA1

Breast

65-85

Ovarian

39-63

Breast

45-84

Ovarian

11-27

BRCA2


Slide 3

BRCA2
 BRCA2 covers approximately 70Kb of genomic DNA of
13q12.
 27 exons make up an approximately 11Kb mRNA,
coding for a 3,418 amino acid protein.
 BRCA2 is involved in double-strand break DNA repair.
 Pathogenic mutations:
• Point mutations (nonsense, missense and splicing alterations)
• Small deletions, duplications and insertions.
• Large, whole exon deletions and duplications.


Slide 4

Current mutation scanning strategy
 Currently both BRCA1 and BRCA2 are screened
concurrently:
• Two week sample collection
• Multiplex ligation-dependent probe amplification (MLPA) for
deletion/duplication detection
• Conformation sensitive capillary electrophoresis (CSCE) prescreen. 33 and 46 amplicons for BRCA1 and BRCA2
• Bi-directional sequencing of any patient amplicons that do not
match the wild-type (WT) or polymorphic controls

 In the last year the results for all BRCA1/2 mutation
scans were reported within the 40-day reporting time.
 However, a high failure rate for CSCE increases the cost
of the screen and can put pressure on reporting times.


Slide 5

High Resolution Melt analysis
 High Resolution Melt (HRM) analysis offers rapid and
low cost detection of sequence variants.
 The DNA region of interest is amplified and heteroduplexed
in the presence of LCGreen.
 LCGreen binds dsDNA to saturation and will emit a
fluorescent signal when incorporated.
 Sequence variants alter the melting profile of a
heteroduplexed sample.
 Fluorescence change, under
controlled melting, is analysed
using the LightScanner
(Idaho Technologies).


Slide 6

BRCA2 primers and validation criteria
 47 primer pairs designed by Idaho Technologies.
 Cover the entire coding region of BRCA2 and at least 15
base pairs either side of coding exons.
 Primers covering sites of known frequency single
nucleotide polymorphisms (SNPs) were modified to
contain inosine or degenerate bases where applicable.
 Validation criteria:
• No false-negative results
• Fewer than 25% false positives


Slide 7

Initial amplicon Validation
 Each amplicon was tested using a panel of 20 wild type
(WT) controls and samples containing all available
amplicon specific variants.
 Using the standard protocol supplied with the primer
sequences, 25 of the 47 amplicons met the validation
criteria.
 Further optimisation was carried out with the remaining
22 amplicons.


Slide 8

Further optimisation
 Primer concentration:





Reduced from 0.25μM to 0.20μM
Number of false-positives reduced
7 amplicons needed lower primer concentrations to meet the
validation criteria
Further reductions decrease the amplification

Amplicon 11-3:

0.25μM

0.20μM
WT

Variant

False-positive


Slide 9

Further optimisation
 PCR cycles:





Cycles increased from 35 to 40
Results improved for all amplicons trialled
Amplification more consistent between samples
Reduced false positive rate and increased variant detection

Amplicon 11-12:

35 cycles

40 cycles
WT

Variant

False-positive


Slide 10

Further optimisation
 Genomic DNA clean up:
• Using CA reagent, supplied by Clent Life Science, prior to
sample dilution
• Reduced variation between samples of the same genotype

Amplicon 10-3:

Untreated DNA
WT

CA reagent cleaned DNA
c.1365A>G
c.1359delA
False-positive


Slide 11

Amplicons that have not met the validation
criteria
 Amplicons 03 and 10-3 both failed to detect a variant:
• c.68-7T>A and c.1359delA respectively
• Both variants lie within mononucleotide tracts close to the end
of their respective fragments
• Other variants have been detected closer to the end of a
fragment
• Variants have also been detected in mononucleotide tracts
E.g. c.8940insA in amplicon 22


Slide 12

Amplicons that have not met the validation
criteria
 Amplicons 10-1b, 10-2 and 11-1 all have problems with
common polymorphisms:
• 10-1b – common SNPs under both primers
• 10-2 – common internal polymorphism, poor results
• 11-1 – three common polymorphisms in fragment

 These five amplicons would be sequenced directly using
alternative primers where appropriate.


Slide 13

Results after optimisation
 After amplicon optimisation 42 of 47 amplicons met the
validation criteria.
Mutation type

Number of variants detected

Number variants not detected

Nucleotide change

106

1

Nucleotide deletion

30

1

Nucleotide duplication

3

0

Nucleotide insertion

1

0

Total

140

2

 140 of 142 variants detected. Sensitivity: 98.6%.

 Not including results from amplicons 10-1b, 10-2 and 11-1.


Slide 14

Summary of validation results





Even amplification and low variation between samples are essential.
All amplicons are now run with the 40-cycle PCR.
Seven amplicons will be amplified using 0.2μM primers.
All samples will be cleaned up prior to dilution using CA reagent.

 Polymorphisms can make analysis difficult.
 WT and polymorphism controls will need to be run with amplicons 115, 11-6, 14-2 and 17 to differentiate WT and polymorphic groups.

Amplicon 17:
WT
c.7806-14T>C Het
c.7806-14T>C Hom
c.7822C>G
c.7927G>A


Slide 15

Advantages of HRM as a pre-screen in the
Nottingham laboratory
 Rapid:



The 42 amplicons for 10 patients can be amplified, analysed and
scored in two days by one person
CSCE would take five days to do the same screen using a 16capillary ABI 3130xl.

 Low cost:



HRM is approximately 35% cheaper than CSCE for consumables
Quick setup and analysis reduce the cost further

 Reduced sequencing:




Very low failure rate
Fewer samples to sequence than CSCE, including the five amplicons
needing direct sequencing
Increased sequencing capacity for other applications


Slide 16

Future work
 Direct comparison to CSCE:




HRM analysis for BRCA2 currently running concurrently with CSCE
using the same patient samples
Will provide more conclusive sensitivity and specificity values
Further validate HRM as a diagnostic tool

 Amplicons requiring further work:



Trial high sensitivity mastermix for amplicons 03 and 10-3
Potentially redesign primers for 10-1b, 10-2 and 11-1


Slide 17

Acknowledgements
 Nottingham Molecular Genetics Service





Rachael Tredwell
Jo Field
Gareth Cross
All staff

 Clent Life Science
• David Harris

 Idaho Technologies
• Jason McKinney