Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers

<b>Introduction:</b> <i>MET</i> Exon 14 skipping alterations are drivers of non-small cell lung carcinoma (NSCLC) with responses to tyrosine kinase inhibitors. Amplicon-based DNA NGS assays (DNA NGSs) for the detection of <i>MET</i>ex14 skipping can yield false-ne...

Full description

Saved in:
Bibliographic Details
Main Authors: Magdalena Jurkiewicz, Raymond Yeh, Catherine A. Shu, Susan J. Hsiao, Mahesh M. Mansukhani, Anjali Saqi, Helen Fernandes
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Journal of Molecular Pathology
Subjects:
Online Access:https://www.mdpi.com/2673-5261/6/1/5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850204473958334464
author Magdalena Jurkiewicz
Raymond Yeh
Catherine A. Shu
Susan J. Hsiao
Mahesh M. Mansukhani
Anjali Saqi
Helen Fernandes
author_facet Magdalena Jurkiewicz
Raymond Yeh
Catherine A. Shu
Susan J. Hsiao
Mahesh M. Mansukhani
Anjali Saqi
Helen Fernandes
author_sort Magdalena Jurkiewicz
collection DOAJ
description <b>Introduction:</b> <i>MET</i> Exon 14 skipping alterations are drivers of non-small cell lung carcinoma (NSCLC) with responses to tyrosine kinase inhibitors. Amplicon-based DNA NGS assays (DNA NGSs) for the detection of <i>MET</i>ex14 skipping can yield false-negative results. We examined the efficacy of <i>MET</i>ex14 skipping with a DNA NGS and reflex RNA-based NGS (RNA NGS) strategy. <b>Materials and Methods</b>: Clinical cases with definitive or suspected lung adenocarcinoma (LungCa), lacking driver mutations with targeted DNA NGS, underwent the RNA NGS to identify oncogenic drivers. Samples with <i>MET</i>ex14 skipping identified on reflex RNA NGSs were confirmed with Sanger sequencing. <b>Results:</b><i>MET</i>ex14 skipping events were detected in 22/762 (2.9%) samples by DNA NGS. RNA NGS identified 10 additional samples, for an overall frequency of 32/762 (4.1%). All 22 <i>MET</i>ex14 DNA variants affected the donor splice site. Sanger sequencing revealed that missed <i>MET</i>ex14 variants were largely deletions spanning the ~30 bp intronic region upstream of the splice acceptor site. The failure of DNA NGS to detect all <i>MET</i>ex14 mutants was due to a lack of coverage of the 3′ splice acceptor site of intron 13, branch point, and polypyrimidine tract. <b>Conclusions:</b> Modification of amplicon-based DNA hotspot assays, with primers that cover both donor and acceptor splice sites, can identify a larger number of <i>MET</i>ex14 skipping events. Clinical data show that patients with advanced NSCLC and <i>MET</i>ex14 variants responded to targeted therapy.
format Article
id doaj-art-e2259a25b9344ef48c52ab00df1e6d28
institution OA Journals
issn 2673-5261
language English
publishDate 2025-02-01
publisher MDPI AG
record_format Article
series Journal of Molecular Pathology
spelling doaj-art-e2259a25b9344ef48c52ab00df1e6d282025-08-20T02:11:17ZengMDPI AGJournal of Molecular Pathology2673-52612025-02-0161510.3390/jmp6010005Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung CancersMagdalena Jurkiewicz0Raymond Yeh1Catherine A. Shu2Susan J. Hsiao3Mahesh M. Mansukhani4Anjali Saqi5Helen Fernandes6Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USADepartment of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY 10032, USA<b>Introduction:</b> <i>MET</i> Exon 14 skipping alterations are drivers of non-small cell lung carcinoma (NSCLC) with responses to tyrosine kinase inhibitors. Amplicon-based DNA NGS assays (DNA NGSs) for the detection of <i>MET</i>ex14 skipping can yield false-negative results. We examined the efficacy of <i>MET</i>ex14 skipping with a DNA NGS and reflex RNA-based NGS (RNA NGS) strategy. <b>Materials and Methods</b>: Clinical cases with definitive or suspected lung adenocarcinoma (LungCa), lacking driver mutations with targeted DNA NGS, underwent the RNA NGS to identify oncogenic drivers. Samples with <i>MET</i>ex14 skipping identified on reflex RNA NGSs were confirmed with Sanger sequencing. <b>Results:</b><i>MET</i>ex14 skipping events were detected in 22/762 (2.9%) samples by DNA NGS. RNA NGS identified 10 additional samples, for an overall frequency of 32/762 (4.1%). All 22 <i>MET</i>ex14 DNA variants affected the donor splice site. Sanger sequencing revealed that missed <i>MET</i>ex14 variants were largely deletions spanning the ~30 bp intronic region upstream of the splice acceptor site. The failure of DNA NGS to detect all <i>MET</i>ex14 mutants was due to a lack of coverage of the 3′ splice acceptor site of intron 13, branch point, and polypyrimidine tract. <b>Conclusions:</b> Modification of amplicon-based DNA hotspot assays, with primers that cover both donor and acceptor splice sites, can identify a larger number of <i>MET</i>ex14 skipping events. Clinical data show that patients with advanced NSCLC and <i>MET</i>ex14 variants responded to targeted therapy.https://www.mdpi.com/2673-5261/6/1/5<i>MET</i> exon 14 skippingDNA NGSRNA sequencinglung adenocarcinoma
spellingShingle Magdalena Jurkiewicz
Raymond Yeh
Catherine A. Shu
Susan J. Hsiao
Mahesh M. Mansukhani
Anjali Saqi
Helen Fernandes
Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
Journal of Molecular Pathology
<i>MET</i> exon 14 skipping
DNA NGS
RNA sequencing
lung adenocarcinoma
title Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
title_full Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
title_fullStr Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
title_full_unstemmed Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
title_short Challenges in Amplicon-Based DNA NGS Identification of MET Exon 14 Skipping Events in Non-Small Cell Lung Cancers
title_sort challenges in amplicon based dna ngs identification of met exon 14 skipping events in non small cell lung cancers
topic <i>MET</i> exon 14 skipping
DNA NGS
RNA sequencing
lung adenocarcinoma
url https://www.mdpi.com/2673-5261/6/1/5
work_keys_str_mv AT magdalenajurkiewicz challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT raymondyeh challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT catherineashu challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT susanjhsiao challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT maheshmmansukhani challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT anjalisaqi challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers
AT helenfernandes challengesinampliconbaseddnangsidentificationofmetexon14skippingeventsinnonsmallcelllungcancers