Leveraging sequences missing from the human genome to diagnose cancer

Abstract Background Cancer diagnosis using cell-free DNA (cfDNA) has the potential to improve treatment and survival but has several technical limitations. Methods In this study, we developed a prediction model based on neomers, DNA sequences 13–17 nucleotides in length that are predominantly absent...

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Main Authors: Ilias Georgakopoulos-Soares, Ofer Yizhar-Barnea, Ioannis Mouratidis, Candace S. Y. Chan, Michail Patsakis, Akshatha Nayak, Rachael Bradley, Mayank Mahajan, Jasmine Sims, Dianne Laboy Cintron, Ryder Easterlin, Julia S. Kim, Emmalyn Chen, Geovanni Pineda, Guillermo E. Parada, John S. Witte, Christopher A. Maher, Felix Feng, Ioannis Vathiotis, Nikolaos Syrigos, Emmanouil Panagiotou, Andriani Charpidou, Konstantinos Syrigos, Jocelyn Chapman, Mark Kvale, Martin Hemberg, Nadav Ahituv
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-01067-3
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Summary:Abstract Background Cancer diagnosis using cell-free DNA (cfDNA) has the potential to improve treatment and survival but has several technical limitations. Methods In this study, we developed a prediction model based on neomers, DNA sequences 13–17 nucleotides in length that are predominantly absent from the genomes of healthy individuals and are created by tumor-associated mutations. Results We show that neomer-based classifiers can accurately detect cancer, including early stages, and distinguish subtypes and features. Analysis of 2577 cancer genomes from 21 cancer types shows that neomers can distinguish tumor types with higher accuracy than state-of-the-art methods. Generation and analysis of 465 cfDNA whole-genome sequences demonstrates that neomers can precisely detect lung and ovarian cancer, including early stages, with an area under the curve ranging from 0.89 to 0.94. By testing various promoters or over 9000 candidate enhancer sequences with massively parallel reporter assays, we show that neomers can identify cancer-associated mutations that alter regulatory activity. Conclusions Combined, our results identify a sensitive, specific, and simple cancer diagnostic tool that can also identify cancer-associated mutations in gene regulatory elements.
ISSN:2730-664X