Genomic Landscape of Cell-Free DNA in Patients with Colorectal Cancer.

Journal Article (Journal Article)

"Liquid biopsy" approaches analyzing cell-free DNA (cfDNA) from the blood of patients with cancer are increasingly utilized in clinical practice. However, it is not yet known whether cfDNA sequencing from large cohorts of patients with cancer can detect genomic alterations at frequencies similar to those observed by direct tumor sequencing, and whether this approach can generate novel insights. Here, we report next-generation sequencing data from cfDNA of 1,397 patients with colorectal cancer. Overall, frequencies of genomic alterations detected in cfDNA were comparable to those observed in three independent tissue-based colorectal cancer sequencing compendia. Our analysis also identified a novel cluster of extracellular domain (ECD) mutations in EGFR , mediating resistance by blocking binding of anti-EGFR antibodies. Patients with EGFR ECD mutations displayed striking tumor heterogeneity, with 91% harboring multiple distinct resistance alterations (range, 1-13; median, 4). These results suggest that cfDNA profiling can effectively define the genomic landscape of cancer and yield important biological insights.Significance: This study provides one of the first examples of how large-scale genomic profiling of cfDNA from patients with colorectal cancer can detect genomic alterations at frequencies comparable to those observed by direct tumor sequencing. Sequencing of cfDNA also generated insights into tumor heterogeneity and therapeutic resistance and identified novel EGFR ectodomain mutations. Cancer Discov; 8(2); 164-73. ©2017 AACR. This article is highlighted in the In This Issue feature, p. 127 .

Full Text

Duke Authors

Cited Authors

  • Strickler, JH; Loree, JM; Ahronian, LG; Parikh, AR; Niedzwiecki, D; Pereira, AAL; McKinney, M; Korn, WM; Atreya, CE; Banks, KC; Nagy, RJ; Meric-Bernstam, F; Lanman, RB; Talasaz, A; Tsigelny, IF; Corcoran, RB; Kopetz, S

Published Date

  • February 2018

Published In

Volume / Issue

  • 8 / 2

Start / End Page

  • 164 - 173

PubMed ID

  • 29196463

Pubmed Central ID

  • PMC5809260

Electronic International Standard Serial Number (EISSN)

  • 2159-8290

International Standard Serial Number (ISSN)

  • 2159-8274

Digital Object Identifier (DOI)

  • 10.1158/


  • eng