Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction

Abstract Tumor tissues obtained in the clinical setting typically have low purity and display treatment-associated genetic heterogeneity, contributing to variants at low variant allele fractions (VAF). We present a pan-cancer landscape and the therapeutic impact of somatic variants detected at low V...

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Main Authors: Saumya D. Sisoudiya, Hanna Tukachinsky, Rachel B. Keller-Evans, Alexa B. Schrock, Richard S. P. Huang, Ole Gjoerup, Michael J. Pishvaian, Rachna Shroff, Ethan S. Sokol, Lucas Dennis, Garrett M. Frampton, Smruthy Sivakumar
Format: Article
Language:English
Published: Nature Portfolio 2025-06-01
Series:npj Precision Oncology
Online Access:https://doi.org/10.1038/s41698-025-00991-w
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author Saumya D. Sisoudiya
Hanna Tukachinsky
Rachel B. Keller-Evans
Alexa B. Schrock
Richard S. P. Huang
Ole Gjoerup
Michael J. Pishvaian
Rachna Shroff
Ethan S. Sokol
Lucas Dennis
Garrett M. Frampton
Smruthy Sivakumar
author_facet Saumya D. Sisoudiya
Hanna Tukachinsky
Rachel B. Keller-Evans
Alexa B. Schrock
Richard S. P. Huang
Ole Gjoerup
Michael J. Pishvaian
Rachna Shroff
Ethan S. Sokol
Lucas Dennis
Garrett M. Frampton
Smruthy Sivakumar
author_sort Saumya D. Sisoudiya
collection DOAJ
description Abstract Tumor tissues obtained in the clinical setting typically have low purity and display treatment-associated genetic heterogeneity, contributing to variants at low variant allele fractions (VAF). We present a pan-cancer landscape and the therapeutic impact of somatic variants detected at low VAF (≤10%) from tumor tissues in 331,503 patients, across 78 tumor types, that received an FDA-approved comprehensive genomic profiling (CGP) test targeting ~324 genes during routine clinical care. 29% of patients had at least one variant detected at VAF ≤10% and 16% at VAF ≤5%. Among the frequently diagnosed tumors, several cases showed low VAF variants: pancreatic (37%), non-small cell lung cancer (35%), colorectal (29%) and prostate (24%). Treatment resistance-associated alterations had lower median VAF than driver alterations, although variants with VAF ≤5% comprised both driver and resistance alterations. This highlights the importance of CGP in detecting low VAF variants, to better inform clinical actionability and guide personalized treatment for patients with cancer.
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issn 2397-768X
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publishDate 2025-06-01
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series npj Precision Oncology
spelling doaj-art-13c3694e1d8f4eb3a9edc367aad1dadb2025-08-20T03:22:46ZengNature Portfolionpj Precision Oncology2397-768X2025-06-01911910.1038/s41698-025-00991-wTissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fractionSaumya D. Sisoudiya0Hanna Tukachinsky1Rachel B. Keller-Evans2Alexa B. Schrock3Richard S. P. Huang4Ole Gjoerup5Michael J. Pishvaian6Rachna Shroff7Ethan S. Sokol8Lucas Dennis9Garrett M. Frampton10Smruthy Sivakumar11Foundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Johns Hopkins University School of MedicineUniversity of Arizona Cancer CenterFoundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Foundation Medicine Inc.Abstract Tumor tissues obtained in the clinical setting typically have low purity and display treatment-associated genetic heterogeneity, contributing to variants at low variant allele fractions (VAF). We present a pan-cancer landscape and the therapeutic impact of somatic variants detected at low VAF (≤10%) from tumor tissues in 331,503 patients, across 78 tumor types, that received an FDA-approved comprehensive genomic profiling (CGP) test targeting ~324 genes during routine clinical care. 29% of patients had at least one variant detected at VAF ≤10% and 16% at VAF ≤5%. Among the frequently diagnosed tumors, several cases showed low VAF variants: pancreatic (37%), non-small cell lung cancer (35%), colorectal (29%) and prostate (24%). Treatment resistance-associated alterations had lower median VAF than driver alterations, although variants with VAF ≤5% comprised both driver and resistance alterations. This highlights the importance of CGP in detecting low VAF variants, to better inform clinical actionability and guide personalized treatment for patients with cancer.https://doi.org/10.1038/s41698-025-00991-w
spellingShingle Saumya D. Sisoudiya
Hanna Tukachinsky
Rachel B. Keller-Evans
Alexa B. Schrock
Richard S. P. Huang
Ole Gjoerup
Michael J. Pishvaian
Rachna Shroff
Ethan S. Sokol
Lucas Dennis
Garrett M. Frampton
Smruthy Sivakumar
Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
npj Precision Oncology
title Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
title_full Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
title_fullStr Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
title_full_unstemmed Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
title_short Tissue-based genomic profiling of 300,000 tumors highlights the detection of variants with low allele fraction
title_sort tissue based genomic profiling of 300 000 tumors highlights the detection of variants with low allele fraction
url https://doi.org/10.1038/s41698-025-00991-w
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