WO2014052613A2 - Methods and compositions relating to next generation sequencing for genetic testing in alk related cancers - Google Patents
Methods and compositions relating to next generation sequencing for genetic testing in alk related cancers Download PDFInfo
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- C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
- C12Q1/00—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
- C12Q1/68—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
- C12Q1/6876—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes
- C12Q1/6883—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material
- C12Q1/6886—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material for cancer
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- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
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Definitions
- ALK anaplastic lymphoma kinase
- ALK small-molecule inhibitors are developed, also need is a clinically applicable diagnostic test to identify resistance mutations in the ALK kinase domain and therefore to guide the rational use of these small-molecule inhibitors for the treatment of ALK-drwen cancers that have lost their responsiveness to -generation inhibitor therapy.
- optimal management of patients with tumors will require screening for de novo inhibitor resistance mutations by healthcare providers treating newly diagnosed patients in order to assess their inhibitor sensitivity and choose the best ALK inhibitor drug(s) for personalized therapy.
- the methods, assays, and compositions disclosed herein relate to the field of detection or diagnosis of mutations that confer resistance to kinase inhibitors of a disease or condition such as cancer.
- the kinase inhibitors or ALK kinase inhibitors are also disclosed herein.
- methods and assays for assessing the susceptibility or risk for developing resistance to an inhibitor, wherein the disease or condition is a cancer associated with expression of the ALK gene It is understood and herein contemplated that the methods disclosed herein allow for rapid and sensitive detection of nucleic acid expression of mutations in ALK.
- kinase inhibitor resistance panels comprising one or more primer sets from each of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
- this invention in one aspect, relates to an ALK kinase inhibitor resistance panel.
- the invention in one aspect, relates to an ALK kinase inhibitor resistance panel comprising one or more primer sets for detecting the presence of a mutation in a gene that will confer resistance to the ALK kinase inhibitor.
- Figure 1 shows XALKORI®-resistance mutations identified in patient specimens.
- the figure depicts the XALKORI®-resistance mutations in the ALK kinase domain identified to date in patient cancer specimens.
- Ranges can be expressed herein as from “about” one particular value, and/or to
- an “increase” can refer to any change that results in a larger amount of a composition or compound, such as an amplification product relative to a control.
- an increase in the amount in amplification products can include but is not limited to a 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 150%, 200%, 250%, 300%, 350%, 400%, 450%, 500%, 550%, 600%, 700%, 800%, 900%, 1000%, 1500%, 2000%, 2500%, 3000%, 3500%, 4000%, 4500%, or 5000% increase.
- the detection an increase in expression or abundance of a DNA, mRNA, or protein relative to a control necessarily includes detection of the presence of the DNA, mRNA, or protein in situations where the DNA, mRNA, or protein is not present in the control.
- tissue samples obtained directly from the subject can be obtained by any means known in the art including invasive and noninvasive techniques. It is also understood that methods of measurement can be direct or indirect. Examples of methods of obtaining or measuring a tissue sample can include but are not limited to tissue biopsy, tissue lavage, blood collection, aspiration, tissue swab, spinal tap, magnetic resonance imaging (MRI), Computed Tomography (CT) scan, Positron Emission Tomography (PET) scan, and X-ray (with and without contrast media).
- MRI magnetic resonance imaging
- CT Computed Tomography
- PET Positron Emission Tomography
- tissue can include, but is not limited to any grouping of one or more cells or analytes to be used in a an ex vivo or in vitro assays.
- Such tissues include but are not limited to blood, saliva, sputum, lymph, cellular mass, and tissue collected from a biopsy.
- kinase inhibitor resistance panels such as, for example, an ALK kinase inhibitor panel.
- Kinase inhibitors are known in the art and have found use in the treatment of, amongst other things, the treatment of cancer.
- cancers involving the overexpression or fusion of Analplastic Lymphoma Kinase can be treated through the use of a kinase inhibitor.
- Kinase inhibitors are known in the art and include, but are not limited to crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib,
- kinase inhibitor resistance panels for detecting susceptibility or resistance to treatment in a subject to a kinase inhibitor comprising crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, or Vemurafenib.
- mutations in the ALK sequence and other genes can lead to kinase inhibitor resistance.
- These mutations can comprise any of the mutations to ALK, KIT, BRAF, KRAS, or EGFR listed in Tables 2, 3, 4, 5, or 6.
- kinase inhibitor panels comprising one or more primer sets that selectively hybridize and can be used to amplify one of the genes selected from group of genes comprising KRAS(SEQ ID NO: 7718), BRAF(SEQ ID NO: 7717), EGFR (SEQ ID NO: 7716), ALK (SEQ ID NO: 7714 and SEQ ID NO: 7717
- the kinase inhibitor resistance panel disclosed herein can comprise one or more primer set(s) that hybridizes and amplifies nucleic acid from exon 1 (SEQ ID NOs: 4601-4880 and 7181-7230) exon 2 (SEQ ID NOs: 4881-5200 and 7231- 7326) or both exons 1 and 2 (SEQ ID NOs: 7327-7610) ofKRAS; exon 18 (SEQ ID NOs: 1641 - 1760 and 5819-5934), exon 19 (SEQ ID NOs : 1761 - 1880), exon 20 (SEQ ID NOs : 1881-2000 and 5934-6042), exon 21 (SEQ ID NOs: 2001-2120 and 6043-6150), exon 22 (SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440), exons 18 and 19 (SEQ ID NOs: 2241-2280), exons 18, 19, and 20 (SEQ ID NOs: 4601-4880 and 71
- the disclosed kinase inhibitor resistant panels can comprise a single primer sets that hybridizes to a single gene, region, or exon of a gene selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.
- a single primer sets for KRAS, BRAF, EGFR, ALK, or KIT multiple primer sets that hybridize to a single gene, region, or exon of a gene selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, one or more primer sets for KRAS, BRAF, EGFR, ALK, or KIT); multiple primer sets comprising a single primer set that specifically hybridize to a single gene, region, or exon for each of the genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, a single primer set for each oiKRAS, BRAF, EGFR, ALK, and/or KIT); or multiple primer sets comprising where in there is more than one primer set for each gene, region or exon for each of the genes selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, one or more primer sets for each oiKRA
- the kinase inhibitor panel can comprise primer sets that recognize and specifically hybridize to a gene, region, or exon, of one or combination of the gene selected from the group consisting oiKRAS, BRAF, EGFR, ALK, and KIT.
- the panel can comprise primer sets that hybridize to a gene, region, or exon oiKRAS, BRAF, EGFR, ALK, or KIT; KRAS and BRAF; KRAS and EGFR; KRAS and ALK; KRAS and KIT; BRAF and EGFR; BRAF and KIT; BRAF and ALK; EGFR and ALK; EGFR and KIT; ALK and KIT; KRAS, BRAF, and EGFR; KRAS, BRAF, and ALK; KRAS, BRAF, and KIT; KRAS, EGFR, and ALK; KRAS, EGFR, and KIT; KRAS, ALK, and KIT; BRAF, EGFR, and ALK; KRAS, EGFR, and KIT; KRAS, ALK, and KIT; BRAF, EGFR, and ALK, BRAF,
- the primer or primer sets in the kinase inhibitor resistance panel can detect any of the mutations in Tables 2-6.
- the primers or primer sets used in the inhibitor resistance panel can comprise one or more of the primers or primer sets listed in Tables 7-14 as disclosed herein and/or probes listed in Table 15 (i.e., SEQ ID NOs: 7611-7613).
- the disclosed kinase inhibitor resistant panels in one aspect, contain primers or primer sets for the detection of mutations that confer kinase inhibitor resistance.
- methods and assays for the detection of kinase inhibitor resistant forms of an ALK-rslatsd cancer are disclosed herein.
- kinase inhibitor resistance such as, for example ALK kinase inhibitor resistance
- a cancer such as a kinase related cancer (e.g., ALK-related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
- the mutation can be a nucleic acid mutation in ALK, EGFR, KRAS, BRAF, or KIT.
- the mutation can be any mutation listed in Tables 2-6.
- the disclosed methods and assays for detection of kinase inhibitor resistance can comprise performing next generation sequencing using a kinase inhibitor resistant panel as disclosed herein which comprises a primer or primer set that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 ⁇ ; exon 10, 11, 13, 14, or 15 oiBRAF, and/or exon 21 , 22, 23, 24, or 25 oiALK.
- the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14.
- exon 1 SEQ ID NOs: 4601-4880 and 7181-7230
- exon 2 SEQ ID NOs: 4881-5200 and 7231- 7326
- both exons 1 and 2 SEQ ID NOs: 7327-7610) oiKRAS
- exon 18 SEQ ID NOs: 1641 - 1760 and 5819-5934
- exon 19 SEQ ID NOs : 1761 - 1880
- exon 20 SEQ ID NOs : 1881-2000 and 5934-6042
- exon 21 SEQ ID NOs: 2001-2120 and 6043-6150
- exon 22 SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440
- exons 18 and 19 SEQ ID NOs: 2241-2280
- exons 18, 19, and 20 SEQ ID NOs: 6151-6274
- the disclosed methods can further comprise synthesizing cDNA from the nucleic acid extracted from a tissue sample before detection of a mutation in ALK, EGFR, KRAS, BRAF, or KIT.
- a cancer such as a kinase related cancer (e.g., ALK-rolatsd cancers); synthesixing cDNA from the tissue sample, and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
- the subject of the disclosed methods can be a subject that has been previously diagnosed with a cancer including but not limited to inflammatory breast cancer, non-small cell lung carcinoma, esophageal squamous cell carcinoma, colorectal carcinoma, Inflammatory myofibroblastic tumor, familial and sporadic neuroblastoma.
- the subject has been previously diagnosed with a cancer that results from ALK, ROS1, RET, DEPDC1 overexpression, dysregulation, or fusion.
- nucleophosmin- ⁇ Z T NPM-ALK
- 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase ATIC-ALK
- CTC-ALK clathrin heavy chain-ALK
- KIF5B-ALK Ran-binding protein 2-ALK
- SEC31L1- ALK SEC31L1- ALK
- tropomyosin ⁇ -. ⁇ ⁇ 3-.4 ⁇ 0, tropomyos -4-ALK
- TRK-fused gene(Large) -ALK TG L -ALK
- TRK-fused gene(Small) -ALK TSGs-ALK
- CARS-ALK EML4- ⁇ ⁇
- ATIC-ALK clathrin heavy chain-ALK
- the present methods could not only be used to diagnose a kinase inhibitor resistant cancer , but diagnose the cancer itself as the subject with a kinase inhibitor resistant cancer would necessarily not only have a cancer, but have a kinase related cancer such as those disclosed herein .
- kinase inhibitor resistance comprising obtaining a tissue sample from a subject with a cancer and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample using one or more primer sets or primer panels with primer sets that specifically hybridizes to one or more of the genes selected from the group consisting of ALK, KRAS, EGFR, KIT, and BRAF, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
- a high throughput sequencing also known as next generation sequencing
- At least one primer sets hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 18, 19, 20, 21 or 22 oiEGFR, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 21, 22, 23, 24, or 25 oiALK, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 8, 9, 10, 11, 12, 13, or 17 ⁇ , and/or wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 10, 11, 13, 14, or 15 oiBRAF.
- one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of Tables 10 and/or 14 (SEQ ID NOs: 4601-5200 and 7181-7610); wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of Tables 8 and/or 12 (1641-2440 and 5819-6524); wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of Tables 7 and/or 1 1 (SEQ ID NOs: 1-1640 and 5201-5818); wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of Table 9 ( SEQ ID NOs: 2441-4600); and/or wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of Table 13 (SEQ ID NOs: 6525-7180).
- kinase inhibitor resistance panel comprising 2, 3, 4, 5, 6, 7, 8, 9, 10, or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
- the panel comprises one or more primer sets for 2, 3, 4, of all 5 of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
- the kinase inhibitor is selected from the group consisting of crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, and Vemurafenib.
- ALK small-molecule drug candidates abrogates related abnormal cell proliferation and promotes apoptosis in ALK-rslatsd tumor cell lines.
- ALK small-molecule inhibitors not only possess marked antitumor activity against ⁇ Z T-related cancers but are also very well tolerated with no limiting target-associated toxicities. Therefore, such small molecules can be used to treat ALK-AnvQn cancers.
- the presence of a mutation in one of the genes associated with an ALK- related cancer can confer resistance to treatment with a kinase inhibitor, such as an ALK kinase inhibitor. Nevertheless, knowledge of the presence of said mutation can still be useful to the practicing physician in assessing the suitability of a treatment or prescribing a particular treatment regimen.
- a mutation in a gene which confers kinase inhibitor resistance such as, for example, ALK kinase inhibitor resistance
- the presence of a mutation can inform the physician to discontinue the course of treatment with one kinase inhibitor due to detection of kinase inhibitor resistance and select a different kinase inhibitor to which the patient is not yet resistant.
- methods and assays for assessing the suitability of an ALK inhibitor treatment for a cancer comprising performing high throughput sequencing on nucleic acid from a tissue sample from the subject; wherein the presence of a mutation in ALK, EGFR, BRAF, KRAS, or KIT indicates a cancer that comprises resistance to an ALK kinase inhibitor.
- a tissue sample from a subject with a cancer such as a kinase related cancer (e.g., ALK-rslatsd cancers); detecting the presence of a mutation through sequencing or other nucleic acid detection technique for the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor and therefore continued use of an inhibitor to which the cancer has become resistant or to which the cancer is already resistant should be discontinued in favor of a cancer to which resistance has not developed.
- a cancer such as a kinase related cancer (e.g., ALK-rslatsd cancers)
- detecting the presence of a mutation through sequencing or other nucleic acid detection technique for the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor and therefore continued use of an inhibitor to which
- any of the disclosed nucleic acid sequencing techniques disclosed herein can be used in these methods.
- methods and assays assessing the suitability of an ALK kinase inhibitor treatment for an ALK related cancer in a subject comprising conducting high throughput sequencing (also known as next generation sequencing) on nucleic acid such as mRNA or DNA from a tissue sample from the subject; wherein the sequencing reaction reveals the nucleic acid sequence for one or more exons ⁇ , BRAF, KRAS, EGFR, and ALK; and wherein the presence of one or more mutations in KIT, BRAF, KRAS, EGFR, and/or ALK indicates the presence of kinase inhibitor resistance.
- high throughput sequencing also known as next generation sequencing
- the mutations can occur in any exon ⁇ , BRAF, KRAS, EGFR, and ALK.
- the mutations can occur in and therefore the primers or primer sets can hybridize to exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 r 22 of EGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 ⁇ ; exon 10, 11, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK.
- the mutation can comprise any one or more of the mutations listed in Tables 2-6. It is further understood that the disclosed methods and assays can further comprise any of the primers disclosed herein in Tables 7-14 or probes listed in Table 15 and utilize the multiplexing PCR techniques disclosed.
- two or more of the disclosed primers and primer sets can comprise a primer panel can be used in methods and assays for the assessment of the suitability of a kinase inhibitor for the treatment of a subjects' cancer.
- the primer panel comprises one or more primers that can detect a nucleic acid mutation in ALK, BRAF, EGFR, KRAS, or KIT.
- the primers or primer sets that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 ⁇ ; exon 10, 1 1, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK.
- the disclosed primer panel can comprise any primer or primer set which detects one or more of the mutations found in Tables 2-6.
- the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14.
- knowledge of kinase inhibitor resistant cancer can be used to screen for a drug that is not a kinase inhibitor.
- a cancer such as a kinase related cancer (e.g., ALK- related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor, and contacting a tissue sample from subject with a cancer with an agent; wherein an agent that inhibits or reduces the growth or development of a kinase inhibitor resistant cancer is not a kinase inhibitor.
- the disclosed methods can further comprise the sue of the kinase inhibitor resistant panels disclosed herein or any of the primers, primer sets or probes disclosed herein.
- the methods can also further comprise the treatment of a subject with a kinase inhibitor resistant cancer with an agent that is identified in the method as not being a kinase inhibitor or discontinuing treatment in a subject with kinase inhibitor resistant cancer with an agent that has been found to be a kinase inhibitor.
- Methods of identifying subjects for participation in clinical trials to screen for new cancer treatments can be useful for establishing clinical trials to screen for drugs that can be used to treat individuals with kinase inhibitor resistant cancers.
- a subject for screening for a drug that can treat a cancer in a subject with a kinase inhibitor resistant cancer for example ALK kinase inhibitor resistance
- a cancer such as a kinase related cancer (e.g., ALK-related cancers); and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor and the subject can be used in trials to screen for a drug to which a kinase inhibitor resistant subject will respond.
- a kinase inhibitor resistant cancer for example ALK kinase inhibitor resistance
- the mutation can be a nucleic acid mutation in ALK, EGFR, KRAS, BRAF, or KIT.
- the mutation can be any mutation listed in Tables 2-6.
- said methods can further comprise synthesizing cDNA from the tissue sample of the subject.
- the disclosed methods can be used in conjunction with any of the kinase inhibitor resistant panels, primer sets, or probes disclosed herein.
- the disclosed methods can be performed using a primer or primer set that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 ⁇ ; exon 10, 1 1, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK.
- the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14.
- exon 1 SEQ ID NOs: 4601-4880 and 7181-7230
- exon 2 SEQ ID NOs: 4881- 5200 and 7231-7326
- both exons 1 and 2 SEQ ID NOs: 7327-7610 ofKRAS
- exon 18 SEQ ID NOs: 1641-1760 and 5819-5934
- exon 19 SEQ ID NOs: 1761-1880
- exon 20 SEQ ID NOs: 1881-2000 and 5934-6042
- exon 21 SEQ ID NOs: 2001-2120 and 6043- 6150
- exon 22 SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440
- exons 18 and 19 SEQ ID NOs: 2241-2280
- exons 18, 19, and 20 SEQ ID NOs: 6151-6274
- the disclosed methods and assays relate to the detection or diagnosis of the presence of a kinase inhibitor resistance, such as, for example, ALK kinase inhibitor resistance, in a disease or condition such as a cancer and methods and assays for the determination of susceptibility or resistance to therapeutic treatment for a disease or condition such as a cancer in a subject comprising detecting the presence or measuring the expression level of nucleic acid (for example, DNA, mRNA, cDNA, RNA, etc) through the use of next generation sequencing (NGS) from a tissue sample from the subject; wherein the presence of a mutations in the nucleic acid code of the KIT, BRAF, KRAS, EGFR, or ALK gene or the ALK gene portion of an ALK fusion construct indicates the presence of a cancer that is resistant to a kinase inhibitor.
- the cancer is associated with
- the kinase inhibitor resistance panels disclosed herein can be used to perform said methods and the detection of one or more of the mutations in Tables 2-6 indicates the presence of kinase inhibitor resistance.
- the disclosed methods can further comprise discontinuing use of a kinase inhibitor to treat a cancer in a subject that has been identified with a kinase inhibitor resistant cancer.
- the disclosed methods can further comprise treating a subject with a kinase inhibitor resistant cancer with a chemotherapeutic that is not a kinase inhibitor.
- a kinase inhibitor resistant cancer such as, for example, an ALK kinase inhibitor resistant cancer
- a cancer such as a kinase related cancer (e.g., ALK-rslatsd cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor; and treating the subject with a chemotherapeutic that is not a kinase inhibitor.
- a kinase inhibitor resistant cancer such as, for example, an ALK kinase inhibitor resistant cancer
- Also disclosed are methods of treating a subject without a kinase inhibitor resistant cancer comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the absence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject does not have a cancer is resistant nor will become resistant to a kinase inhibitor; and treating the subject with a kinase inhibitor.
- a cancer such as a kinase related cancer (e.g., ALK-related cancers)
- a high throughput sequencing also known as next generation sequencing
- ALK (SEQ ID NO: 7714 (Genbank Accession No. U62540 (human coding sequence)) is a receptor tyrosine kinase (RTK) of the insulin receptor superfamily encoded by the ALK gene and is normally expressed primarily in the central and peripheral nervous systems.
- the I620aa ALK polypeptide comprises a 1030aa extracellular domain which includes a 26aa amino-terminal signal peptide sequence, and binding sites located between residues 391 and 401 for the ALK ligands pleiotrophin (PTN) and midkine (MK).
- the ALK polypeptide comprises a kinase domain (residues 1 1 16-1383) which includes three tyrosines responsible for autophosphorylation within the activation loop at residues 1278, 1282, and 1283.
- ALK amplification, overexpression, and mutations have been shown to constitutively activate the kinase catalytic function of the ALK protein, with the deregulated mutant ALK in turn activating downstream cellular signaling proteins in pathways that promote aberrant cell proliferation.
- the mutations that result in dysregulated ALK kinase activity are associated with several types of cancers.
- ALK fusions represent the most common mutation of this tyrosine kinase.
- Such fusions include but are not limited to nucleophosmin- ⁇ Z T (NPM-ALK), 5-aminoimidazole- 4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase (ATIC-ALK), clathrin heavy chain-ALK (CLTC-ALK), kinesin-1 heavy chain gsm-ALK (KIF 5B-ALK); Ran- binding protein 2-ALK (RANBP2-ALK), SEC3 I l-ALK, tropomyosin-3- ⁇ " (TPM3- ALK), tropomyosin ⁇ (TFM4-ALK), TRK-fused gene(Large) -ALK (TFG L -ALK),
- TRK-fused gene(Small) -ALK (TFG S -ALK), CARS-ALK, LML4-ALK, 5-aminoimidazole-4- carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase-ALK (ATIC-ALK), ALO 17 -ALK, moesin- ⁇ Z T (MSN-ALK), non-muscle myosin heavy chain gsns-ALK (MYH9-ALK), and TRK-fused gene(Extra Large) -ALK (TFG XL -ALK).
- TGF S -ALK TGF
- CARS-ALK CARS-ALK
- LML4-ALK 5-aminoimidazole-4- carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase-ALK
- ATIC-ALK 5-aminoimidazole-4- carboxamide ribonucleotide
- CLTC-ALK, RA BP2- ⁇ ⁇ , SEC3 -ALK, TFM3-ALK, and TFM4-ALK have been identified in IMTs.
- TPMS-ALK, TPM4-ALK and CLTC-ALK fusions have been detected in both classical T- or null-cell lymphomas and IMT sarcomas, whereas CARS- ALK, RA BP2- ⁇ ⁇ , and SEC3 ILI-ALK occur in IMT.
- CLTC-ALK and NFM-ALK also occur in B-cell plasmablastic/immunoblastic lymphomas.
- the TPM4-ALK fusion occurs in esophageal squamous cell carcinomas, and the ALK fusion LML4-ALK , TFG-ALK and
- Y T5B-ALK are found in non-small cell lung cancers. EML4-ALK has also recently been identified in both colorectal and breast carcinomas as well. ALK fusions are associated with several known cancer types. It is understood that one or more ALK fusions can be associated with a particular cancer.
- ALK anaplastic large-cell lymphoma
- neuroblastoma neuroblastoma
- breast cancer breast cancer
- ovarian cancer colorectal carcinoma
- non-small cell lung carcinoma diffuse large B-cell lymphoma
- esophageal squamous cell carcinoma anaplastic large-cell lymphoma
- neuroblastoma inflammatory myofibroblastic tumors
- malignant histiocytosis malignant histiocytosis
- glioblastomas glioblastomas.
- ALCL anaplastic large-cell lymphomas comprise -2.5% of all NHL; within the pediatric age group specifically, -13% of all NHL (30 - 40% of all childhood large-cell lymphomas) are of this type.
- more than a third of patients suffer multiple relapses following chemotherapy, thus the 5-year disease-free survival of ALK-positive ALCL is only -40%.
- ALK+ Diffuse large B-cell lymphoma In 2003, ALK fusions were shown to occur in a non-ALCL form of NHL with the description of CLTC-ALK or NPM-ALK in diffuse large B-cell lymphomas (ALK+ DLBCLs). Consistent with their B-lineage, these NHLs express cytoplasmic IgA and plasma cell markers, and possess an immunoblastic morphology. Translational research studies revealed the t(2; 17) and CLTC-ALK mRN A in the majority of these lymphomas, while immunolabeling confirmed granular ALK staining identical to that observed in CLTC-ALK-positive ALCL.
- ALK+ DLBCLs occur predominately in adults; however, the t(2;5) and NPM-ALK mRNA in pediatric lymphomas are phenotypically identical to CLTC-ALK- positive adult B-NHLs. Approximately 0.5-1% of all DLBCL is thought to be ALK-positive.
- DLBCLs caused by mutant ALK are important because patients with these lymphomas have outcomes that are much inferior to ALK-negative DLBCL patients following CHOP-based treatments; thus, ALK+ DLBCL patients should strongly be considered as candidates for ALK-targeted kinase inhibitor therapy.
- ALK+ systemic histiocytosis ALK+ systemic histiocytosis. ALK fusions were described in 2008 in another hematopoietic neoplasm, systemic histiocytosis. Three cases of this previously
- constitutively activated ALK fusions have been shown to be a causative mechanism in many cases, the genesis of subsets of various solid tumors in some instances, very common human tumors such as non-small cell lung cancer, colorectal and breast cancers has recently been demonstrated to be due to aberrantly activated ALK.
- IMT inflammatory myofibroblastic tumor
- ALK inflammatory myofibroblastic tumor
- Many IMTs are indolent and can be cured by resection.
- locally recurrent, invasive, and metastatic IMTs are not uncommon and current chemo- and radio-therapies are completely ineffective.
- Disclosed herein is the involvement of chromosome 2p23 (the location of the ALK gene) in IMTs, as well as ALK gene rearrangement.
- ALK immunoreactivity in 7 of 11 IMTs has been shown and TPM3-ALK and TPM4-ALK were identified in several cases. Additionally, two additional ALK fusions in IMT, CLTC- and RanBP2-ALK were identified. ALK fusions have also been examined by immunostaining in 73 IMTs, finding 60% (44 of the 73 cases) to be ALK-positive. Thus, ALK deregulation is of pathogenic importance in a majority of IMTs.
- Non-small cell lung carcinoma Non-small cell lung carcinoma.
- the role of ALK fusions in cancer expanded further with the description of the novel EML4-ALK chimeric protein in 5 of 75 (6.7%) Japanese non-small cell lung carcinoma patients.
- Shortly thereafter, the existence of ALK fusions in lung cancer was corroborated by a different group who found 6 of 137 (4.4%) Chinese lung cancer patients to express ALK fusions (EML4-ALK, 3 pts; TFG-ALK, 1 pt; X-ALK.
- ALK fusions occur predominately in patients with adenocarcinoma (although occasional ALK-positive NSCLCs of squamous or mixed histologies are observed), mostly in individuals with minimal/no smoking history, and 2) ALK abnormalities usually occur exclusive of other common genetic abnormalities (e.g., EGFR and KRAS mutations).
- ALK abnormalities usually occur exclusive of other common genetic abnormalities (e.g., EGFR and KRAS mutations).
- the exact percentage of NSCLCs caused by ALK fusions is not yet clear but estimates based on reports in the biomedical literature suggest a range of -5-10%.
- Esophageal squamous cell carcinoma In 45 Egyptian patients, a proteomics approach identified proteins under or over-represented in esophageal squamous cell carcinomas (ESCCs); TPM4-ALK was among those proteins over-represented.
- ESCCs esophageal squamous cell carcinomas
- a second proteomics- based ESCC study - in this case, in Chinese patients - identified TPM4-ALK in these tumors as well.
- ALK in familial and sporadic neuroblastoma Neuroblastoma is the most common extracranial solid tumor of childhood, and is derived from the developing neural crest. A small subset (-1-2%) of neuroblastomas exhibit a familial predisposition with an autosomal dominant inheritance. Most neuroblastoma patients have aggressive disease associated with survival probabilities ⁇ 40% despite intensive chemo- and radio-therapy, and the disease accounts for -15% of all childhood cancer mortality. ALK had previously been found to be constitutively activated also due to high-level over-expression as a result of gene amplification in a small number of neuroblastoma cell lines, in fact, ALK amplification occurs in -15% of neuroblastomas in addition to activating point mutations.
- missense mutations in ALK have been confirmed as activating mutations that drive neuroblastoma growth; furthermore, incubation of neuroblastoma cell lines with ALK small-molecule inhibitors reveal those cells with ALK activation (but not cell lines with normal levels of expression of wild-type ALK) to exhibit robust cytotoxic responses.
- Allele specific primers can be designed to target a mutation at a known location such that its signal can be preferentially amplified over wild-type DNA.
- NGS Next Generation Sequencing
- the methods and assays for detecting kinase inhibitor resistance or determining the susceptibility or developing kinase inhibitor resistance in an ALK-related cancer or determining the suitability of a particular kinase inhibitor for use in treating an ALK-related cancer in a subject can comprise the detection of any of the mutations in Tables 2-6. It is understood that the methods and assays can further comprise comparing the sequence to known kinase inhibitor resistance mutations list and determining what if any kinase inhibitors are affected by the mutation and altering or maintaining treatment as appropriate to utilize kinase inhibitors that are unaffected by the mutation.
- primer panels for use in next generation sequencing for the determination of kinase inhibitor resistance comprising one or more primer sets from each ⁇ , BRAF, KRAS, EGFR, and ALK
- the disclosed primer panels, methods, and assays can comprise one or more of the primers or primer sets listed in Tables 7-14.
- Next Generation Sequencing techniques include, but are not limited to Massively Parallel Signature Sequencing (MPSS), Polony sequencing, pyrosequencing,
- Reversible dye-terminator sequencing SOLiD sequencing, Ion semiconductor sequencing, DNA nanoball sequencing, Helioscope single molecule sequencing, Single molecule real time (SMRT) sequencing, Single molecule real time (RNAP) sequencing, and Nanopore DNA sequencing.
- MPSS was a bead-based method that used a complex approach of adapter ligation followed by adapter decoding, reading the sequence in increments of four nucleotides; this method made it susceptible to sequence-specific bias or loss of specific sequences.
- Polony sequencing combined an in vitro paired-tag library with emulsion PCR, an automated microscope, and ligation-based sequencing chemistry to sequence an E. coli genome at an accuracy of > 99.9999% and a cost approximately 1/10 that of Sanger sequencing.
- a parallelized version of pyrosequencing the method amplifies DNA inside water droplets in an oil solution (emulsion PCR), with each droplet containing a single DNA template attached to a single primer-coated bead that then forms a clonal colony.
- the sequencing machine contains many picolitre-volume wells each containing a single bead and sequencing enzymes. Pyrosequencing uses luciferase to generate light for detection of the individual nucleotides added to the nascent DNA, and the combined data are used to generate sequence read-outs. This technology provides intermediate read length and price per base compared to Sanger sequencing on one end and Solexa and SOLiD on the other.
- a sequencing technology based on reversible dye-terminators DNA molecules are first attached to primers on a slide and amplified so that local clonal colonies are formed. Four types of reversible terminator bases (RT-bases) are added, and non-incorporated nucleotides are washed away. Unlike pyrosequencing, the DNA can only be extended one nucleotide at a time. A camera takes images of the fluorescently labeled nucleotides, then the dye along with the terminal 3' blocker is chemically removed from the DNA, allowing the next cycle.
- RT-bases reversible terminator bases
- SOLiD technology employs sequencing by ligation.
- a pool of all possible oligonucleotides of a fixed length are labeled according to the sequenced position.
- Oligonucleotides are annealed and ligated; the preferential ligation by DNA ligase for matching sequences results in a signal informative of the nucleotide at that position.
- the DNA is amplified by emulsion PCR.
- the resulting bead, each containing only copies of the same DNA molecule, are deposited on a glass slide. The result is sequences of quantities and lengths comparable to Illumina sequencing.
- Ion semiconductor sequencing is based on using standard sequencing chemistry, but with a novel, semiconductor based detection system. This method of sequencing is based on the detection of hydrogen ions that are released during the polymerization of DNA, as opposed to the optical methods used in other sequencing systems.
- a micro well containing a template DNA strand to be sequenced is flooded with a single type of nucleotide. If the introduced nucleotide is complementary to the leading template nucleotide it is incorporated into the growing complementary strand. This causes the release of a hydrogen ion that triggers a hypersensitive ion sensor, which indicates that a reaction has occurred. If homopolymer repeats are present in the template sequence multiple nucleotides will be incorporated in a single cycle. This leads to a corresponding number of released hydrogens and a proportionally higher electronic signal.
- DNA nanoball sequencing is a type of high throughput sequencing technology used to determine the entire genomic sequence of an organism.
- the method uses rolling circle replication to amplify small fragments of genomic DNA into DNA nanoballs. Unchained sequencing by ligation is then used to determine the nucleotide sequence. This method of DNA sequencing allows large numbers of DNA nanoballs to be sequenced per run.
- Helicos's single-molecule sequencing uses DNA fragments with added polyA tail adapters, which are attached to the flow cell surface.
- the next steps involve extension-based sequencing with cyclic washes of the flow cell with fluorescently labeled nucleotides (one nucleotide type at a time, as with the Sanger method).
- the reads are performed by the Helioscope sequencer.
- SMRT sequencing is based on the sequencing by synthesis approach.
- the DNA is synthesized in zero-mode wave-guides (ZMWs) - small well-like containers with the capturing tools located at the bottom of the well.
- ZMWs zero-mode wave-guides
- the sequencing is performed with use of unmodified polymerase (attached to the ZMW bottom) and fluorescently labeled nucleotides flowing freely in the solution.
- the wells are constructed in a way that only the fluorescence occurring by the bottom of the well is detected.
- the fluorescent label is detached from the nucleotide at its incorporation into the DNA strand, leaving an unmodified DNA strand.
- RNA polymerase Single molecule real time sequencing based on RNA polymerase (RNAP), which is attached to a polystyrene bead, with distal end of sequenced DNA is attached to another bead, with both beads being placed in optical traps.
- RNAP motion during transcription brings the beads in closer and their relative distance changes, which can then be recorded at a single nucleotide resolution.
- the sequence is deduced based on the four readouts with lowered concentrations of each of the four nucleotide types (similarly to Sangers method).
- Nanopore sequencing is based on the readout of electrical signal occurring at nucleotides passing by alpha-hemolysin pores covalently bound with cyclodextrin.
- the DNA passing through the nanopore changes its ion current. This change is dependent on the shape, size and length of the DNA sequence.
- Each type of the nucleotide blocks the ion flow through the pore for a different period of time.
- VisiGen Biotechnologies uses a specially engineered DNA polymerase.
- This polymerase acts as a sensor - having incorporated a donor fluorescent dye by its active centre.
- This donor dye acts by FRET (fluorescent resonant energy transfer), inducing fluorescence of differently labeled nucleotides.
- FRET fluorescent resonant energy transfer
- Sequencing by hybridization is a non-enzymatic method that uses a DNA microarray.
- a single pool of DNA whose sequence is to be determined is fluorescently labeled and hybridized to an array containing known sequences. Strong hybridization signals from a given spot on the array identify its sequence in the DNA being sequenced.
- Mass spectrometry may be used to determine mass differences between DNA fragments produced in chain-termination reactions.
- SBS sequencing by synthesis
- the SBS NGS platform uses a direct sequencing approach to produce a sequencing strategy with very a high precision, rapid pace and low cost.
- SBS sequencing is initialized by fragmenting of the template DNA into fragments, amplification, annealing of DNA sequencing primers, and finally affixing as a high-density array of spots onto a glass chip.
- the array of DNA fragments are sequenced by extending each fragment with modified nucleotides containing cleavable chemical moieties linked to fluorescent dyes capable of discriminating all four possible nucleotides.
- the array is scanned continuously by a high-resolution electronic camera (Measure) to determine the fluorescent intensity of each base (A, C, G or T) that was newly incorporated into the extended DNA fragment. After the incorporation of each modified base the array is exposed to cleavage chemistry to break off the fluorescent dye and end cap allowing additional bases to be added. The process is then repeated until the fragment is completely sequenced or maximal read length has been achieved.
- specific mRNAs can be detected using Northern blot analysis, nuclease protection assays (NPA), in situ hybridization (e.g., fluorescence in situ hybridization (FISH)), or reverse transcription- polymerase chain reaction (RT-PCR), and microarray.
- NPA nuclease protection assays
- FISH fluorescence in situ hybridization
- RT-PCR reverse transcription- polymerase chain reaction
- each of these techniques can be used to detect specific RNAs and to precisely determine their expression level.
- Northern analysis is the only method that provides information about transcript size, whereas NPAs are the easiest way to simultaneously examine multiple messages.
- In situ hybridization is used to localize expression of a particular gene within a tissue or cell type, and RT-PCR is the most sensitive method for detecting and quantitating gene expression.
- RT-PCR allows for the detection of the RNA transcript of any gene, regardless of the scarcity of the starting material or relative abundance of the specific mRNA.
- an RNA template is copied into a complementary DNA (cDNA) using a retroviral reverse transcriptase.
- the cDNA is then amplified exponentially by PCR using a DNA polymerase.
- the reverse transcription and PCR reactions can occur in the same or difference tubes.
- RT-PCR is somewhat tolerant of degraded RNA. As long as the RNA is intact within the region spanned by the primers, the target will be amplified.
- Relative quantitative RT-PCR involves amplifying an internal control
- the internal control is used to normalize the samples. Once normalized, direct comparisons of relative abundance of a specific mRNA can be made across the samples. It is crucial to choose an internal control with a constant level of expression across all experimental samples (i.e., not affected by experimental treatment). Commonly used internal controls (e.g., GAPDH, ⁇ -actin, cyclophilin) often vary in expression and, therefore, may not be appropriate internal controls. Additionally, most common internal controls are expressed at much higher levels than the mRNA being studied. For relative RT-PCR results to be meaningful, all products of the PCR reaction must be analyzed in the linear range of amplification. This becomes difficult for transcripts of widely different levels of abundance.
- RT-PCR is used for absolute quantitation. This technique involves designing, synthesizing, and accurately quantitating a competitor RNA that can be distinguished from the endogenous target by a small difference in size or sequence. Known amounts of the competitor RNA are added to experimental samples and RT-PCR is performed. Signals from the endogenous target are compared with signals from the competitor to determine the amount of target present in the sample.
- Northern analysis is the easiest method for determining transcript size, and for identifying alternatively spliced transcripts and multigene family members. It can also be used to directly compare the relative abundance of a given message between all the samples on a blot.
- the Northern blotting procedure is straightforward and provides opportunities to evaluate progress at various points (e.g., intactness of the RNA sample and how efficiently it has transferred to the membrane).
- RNA samples are first separated by size via electrophoresis in an agarose gel under denaturing conditions. The RNA is then transferred to a membrane, crosslinked and hybridized with a labeled probe.
- Nonisotopic or high specific activity radiolabeled probes can be used including random-primed, nick-translated, or PCR-generated DNA probes, in vitro transcribed RNA probes, and oligonucleotides. Additionally, sequences with only partial homology (e.g., cDNA from a different species or genomic DNA fragments that might contain an exon) may be used as probes.
- the Nuclease Protection Assay (including both ribonuclease protection assays and SI nuclease assays) is a sensitive method for the detection and quantitation of specific mRNAs.
- the basis of the NPA is solution hybridization of an antisense probe (radiolabeled or nonisotopic) to an RNA sample. After hybridization, single-stranded, unhybridized probe and RNA are degraded by nucleases. The remaining protected fragments are separated on an acrylamide gel. Solution hybridization is typically more efficient than membrane-based hybridization, and it can accommodate up to 100 ⁇ g of sample RNA, compared with the 20-30 ⁇ g maximum of blot hybridizations. NPAs are also less sensitive to RNA sample degradation than Northern analysis since cleavage is only detected in the region of overlap with the probe (probes are usually about 100-400 bases in length).
- NPAs are the method of choice for the simultaneous detection of several RNA species. During solution hybridization and subsequent analysis, individual probe/target interactions are completely independent of one another. Thus, several RNA targets and appropriate controls can be assayed simultaneously (up to twelve have been used in the same reaction), provided that the individual probes are of different lengths. NPAs are also commonly used to precisely map mRNA termini and intron/exon junctions.
- ISH In situ hybridization
- ISH provides information about the location of mRNA within the tissue sample.
- the procedure begins by fixing samples in neutral-buffered formalin, and embedding the tissue in paraffin. The samples are then sliced into thin sections and mounted onto microscope slides. (Alternatively, tissue can be sectioned frozen and post-fixed in paraformaldehyde.) After a series of washes to dewax and rehydrate the sections, a Proteinase K digestion is performed to increase probe accessibility, and a labeled probe is then hybridized to the sample sections. Radiolabeled probes are visualized with liquid film dried onto the slides, while non-isotopically labeled probes are conveniently detected with colorimetric or fluorescent reagents.
- the methods, assays, and primer panels disclosed herein relate to the detection of nucleic acid variation that confer kinase inhibitor resistance in the form of, for example, point mutations and truncations of, KRAS, BRAF, KIT, EGFR, and/or ALK.
- methods, assays, and use of the disclosed primer panels for diagnosing an anaplastic lymphoma kinase (ALK) related cancer in a subject is resistant to a kinase inhibitor comprise performing NGS which sequences DNA from a tissue sample from the subject.
- high throughput sequencing methods also known as next generation sequencing methods
- PCR a number of widely used procedures exist for detecting and determining the abundance of a particular DNA in a sample.
- the technology of PCR permits amplification and subsequent detection of minute quantities of a target nucleic acid. Details of PCR are well described in the art, including, for example, U.S. Pat. Nos. 4,683, 195 to Mullis et al, 4,683,202 to Mullis and 4,965, 188 to Mullis et al.
- oligonucleotide primers are annealed to the denatured strands of a target nucleic acid, and primer extension products are formed by the polymerization of deoxynucleoside triphosphates by a polymerase.
- a typical PCR method involves repetitive cycles of template nucleic acid denaturation, primer annealing and extension of the annealed primers by the action of a thermostable polymerase. The process results in exponential amplification of the target nucleic acid, and thus allows the detection of targets existing in very low concentrations in a sample. It is understood and herein contemplated that there are variant PCR methods known in the art that may also be utilized in the disclosed methods, for example,
- QPCR Quantitative PCR
- microarrays real-time PCR
- hot start PCR hot start PCR
- nested PCR allele-specific PCR
- Touchdown PCR PCR
- An array is an orderly arrangement of samples, providing a medium for matching known and unknown DNA samples based on base-pairing rules and automating the process of identifying the unknowns.
- An array experiment can make use of common assay systems such as microplates or standard blotting membranes, and can be created by hand or make use of robotics to deposit the sample.
- arrays are described as macroarrays or microarrays, the difference being the size of the sample spots.
- Macroarrays contain sample spot sizes of about 300 microns or larger and can be easily imaged by existing gel and blot scanners.
- the sample spot sizes in microarray can be 300 microns or less, but typically less than 200 microns in diameter and these arrays usually contains ⁇ thousands of spots.
- Microarrays require specialized robotics and/or imaging equipment that generally are not commercially available as a complete system. Terminologies that have been used in the literature to describe this technology include, but not limited to: biochip, DNA chip, DNA microarray, GENECHIP® (Affymetrix, Inc which refers to its high density,
- oligonucleotide-based DNA arrays oligonucleotide-based DNA arrays
- gene array oligonucleotide-based DNA arrays
- DNA microarrays or DNA chips are fabricated by high-speed robotics, generally on glass or nylon substrates, for which probes with known identity are used to determine complementary binding, thus allowing massively parallel gene expression and gene discovery studies. An experiment with a single DNA chip can provide information on thousands of genes simultaneously. It is herein contemplated that the disclosed microarrays can be used to monitor gene expression, disease diagnosis, gene discovery, drug discovery (pharmacogenomics), and toxicological research or toxicogenomics.
- Type I microarrays comprise a probe cDNA (500-5,000 bases long) that is immobilized to a solid surface such as glass using robot spotting and exposed to a set of targets either separately or in a mixture. This method is traditionally referred to as DNA microarray.
- Type I microarrays localized multiple copies of one or more polynucleotide sequences, preferably copies of a single
- polynucleotide sequence are immobilized on a plurality of defined regions of the substrate's surface.
- a polynucleotide refers to a chain of nucleotides ranging from 5 to 10,000 nucleotides. These immobilized copies of a polynucleotide sequence are suitable for use as probes in hybridization experiments.
- Typical dispensers include a micropipette delivering solution to the substrate with a robotic system to control the position of the micropipette with respect to the substrate. There can be a multiplicity of dispensers so that reagents can be delivered to the reaction regions simultaneously.
- a microarray is formed by using ink-jet technology based on the piezoelectric effect, whereby a narrow tube containing a liquid of interest, such as oligonucleotide synthesis reagents, is encircled by an adapter. An electric charge sent across the adapter causes the adapter to expand at a different rate than the tube and forces a small drop of liquid onto a substrate.
- a liquid of interest such as oligonucleotide synthesis reagents
- Samples may be any sample containing polynucleotides (polynucleotide targets) of interest and obtained from any bodily fluid (blood, urine, saliva, phlegm, gastric juices, etc.), cultured cells, biopsies, or other tissue preparations.
- DNA or RNA can be isolated from the sample according to any of a number of methods well known to those of skill in the art. In one embodiment, total RNA is isolated using the TRIzol total RNA isolation reagent (Life Technologies, Inc., Rockville, Md.) and RNA is isolated using oligo d(T) column chromatography or glass beads. After hybridization and processing, the
- hybridization signals obtained should reflect accurately the amounts of control target polynucleotide added to the sample.
- the plurality of defined regions on the substrate can be arranged in a variety of formats.
- the regions may be arranged perpendicular or in parallel to the length of the casing.
- the targets do not have to be directly bound to the substrate, but rather can be bound to the substrate through a linker group.
- the linker groups may typically vary from about 6 to 50 atoms long. Linker groups include ethylene glycol oligomers, diamines, diacids and the like. Reactive groups on the substrate surface react with one of the terminal portions of the linker to bind the linker to the substrate. The other terminal portion of the linker is then functionalized for binding the probes.
- Sample polynucleotides may be labeled with one or more labeling moieties to allow for detection of hybridized probe/target polynucleotide complexes.
- the labeling moieties can include compositions that can be detected by spectroscopic, photochemical, biochemical, bioelectronic, immunochemical, electrical, optical or chemical means.
- labeling moieties include radioisotopes, such as JZ P, or JJ S, chemiluminescent compounds, labeled binding proteins, heavy metal atoms, spectroscopic markers, such as fluorescent markers and dyes, magnetic labels, linked enzymes, mass spectrometry tags, spin labels, electron transfer donors and acceptors, biotin, and the like.
- Labeling can be carried out during an amplification reaction, such as polymerase chain reaction and in vitro or in vivo transcription reactions.
- the labeling moiety can be incorporated after hybridization once a probe-target complex his formed.
- biotin is first incorporated during an amplification step as described above. After the hybridization reaction, unbound nucleic acids are rinsed away so that the only biotin remaining bound to the substrate is that attached to target polynucleotides that are hybridized to the polynucleotide probes. Then, an avidin-conjugated fluorophore, such as avidin-phycoerythrin, that binds with high affinity to biotin is added.
- avidin-conjugated fluorophore such as avidin-phycoerythrin
- Hybridization causes a polynucleotide probe and a complementary target to form a stable duplex through base pairing.
- Hybridization methods are well known to those skilled in the art.
- Stringent conditions for hybridization can be defined by salt concentration, temperature, and other chemicals and conditions. Varying additional parameters, such as hybridization time, the concentration of detergent (sodium dodecyl sulfate, SDS) or solvent (formamide), and the inclusion or exclusion of carrier DNA, are well known to those skilled in the art. Additional variations on these conditions will be readily apparent to those skilled in the art.
- the polynucleotide probes are labeled with a fluorescent label and measurement of levels and patterns of complex formation is accomplished by fluorescence microscopy, preferably confocal fluorescence microscopy.
- An argon ion laser excites the fluorescent label, emissions are directed to a photomultiplier and the amount of emitted light detected and quantitated.
- the detected signal should be proportional to the amount of probe/target polynucleotide complex at each position of the microarray.
- the fluorescence microscope can be associated with a computer-driven scanner device to generate a quantitative two-dimensional image of hybridization intensities. The scanned image is examined to determine the abundance/expression level of each hybridized target polynucleotide.
- polynucleotide targets from two or more different biological samples are labeled with two or more different fluorescent labels with different emission wavelengths. Fluorescent signals are detected separately with different photomultipliers set to detect specific wavelengths. The relative abundances/expression levels of the target polynucleotides in two or more samples is obtained.
- microarray fluorescence intensities can be normalized to take into account variations in hybridization intensities when more than one microarray is used under similar test conditions.
- individual polynucleotide probe/target complex hybridization intensities are normalized using the intensities derived from internal normalization controls contained on each microarray.
- Type II microarrays comprise an array of oligonucleotides (20 ⁇ 80-mer oligos) or peptide nucleic acid (PNA) probes that is synthesized either in situ (on-chip) or by conventional synthesis followed by on-chip immobilization. The array is exposed to labeled sample DNA, hybridized, and the identity/abundance of complementary sequences are determined.
- This method "historically” called DNA chips, was developed at Affymetrix, Inc. , which sells its photolithographically fabricated products under the GENECHIP® trademark.
- Type II arrays for gene expression are simple: labeled cDNA or cRNA targets derived from the mRNA of an experimental sample are hybridized to nucleic acid probes attached to the solid support. By monitoring the amount of label associated with each DNA location, it is possible to infer the abundance of each mRNA species represented.
- hybridization has been used for decades to detect and quantify nucleic acids, the combination of the miniaturization of the technology and the large and growing amounts of sequence information, have enormously expanded the scale at which gene expression can be studied.
- Microarray manufacturing can begin with a 5 -inch square quartz wafer. Initially the quartz is washed to ensure uniform hydroxylation across its surface. Because quartz is naturally hydroxylated, it provides an excellent substrate for the attachment of chemicals, such as linker molecules, that are later used to position the probes on the arrays.
- chemicals such as linker molecules
- the wafer is placed in a bath of silane, which reacts with the hydroxyl groups of the quartz, and forms a matrix of covalently linked molecules.
- the distance between these silane molecules determines the probes' packing density, allowing arrays to hold over 500,000 probe locations, or features, within a mere 1.28 square centimeters. Each of these features harbors millions of identical DNA molecules.
- the silane film provides a uniform hydroxyl density to initiate probe assembly.
- Linker molecules, attached to the silane matrix provide a surface that may be spatially activated by light. Probe synthesis occurs in parallel, resulting in the addition of an A, C, T, or G nucleotide to multiple growing chains simultaneously.
- photolithographic masks carrying 18 to 20 square micron windows that correspond to the dimensions of individual features, are placed over the coated wafer. The windows are distributed over the mask based on the desired sequence of each probe.
- ultraviolet light is shone over the mask in the first step of synthesis, the exposed linkers become deprotected and are available for nucleotide coupling.
- a solution containing a single type of deoxynucleotide with a removable protection group is flushed over the wafer's surface.
- the nucleotide attaches to the activated linkers, initiating the synthesis process.
- oligonucleotide can be occupied by lof Nucleotides, resulting in an apparent need for 25 x 4, or 100, different masks per wafer, the synthesis process can be designed to significantly reduce this requirement.
- Algorithms that help minimize mask usage calculate how to best coordinate probe growth by adjusting synthesis rates of individual probes and identifying situations when the same mask can be used multiple times.
- Hybridization under particular pH, salt, and temperature conditions can be optimized by taking into account melting temperatures and using empirical rules that correlate with desired hybridization behaviors.
- probes are selected from regions shared by multiple splice or polyadenylation variants. In other cases, unique probes that distinguish between variants are favored. Inter-probe distance is also factored into the selection process.
- a different set of strategies is used to select probes for genotyping arrays that rely on multiple probes to interrogate individual nucleotides in a sequence.
- the identity of a target base can be deduced using four identical probes that vary only in the target position, each containing one of the four possible bases.
- the presence of a consensus sequence can be tested using one or two probes representing specific alleles.
- arrays with many probes can be created to provide redundant information, resulting in unequivocal genotyping.
- generic probes can be used in some applications to maximize flexibility.
- Some probe arrays allow the separation and analysis of individual reaction products from complex mixtures, such as those used in some protocols to identify single nucleotide polymorphisms (SNPs).
- Real-time PCR monitors the fluorescence emitted during the reaction as an indicator of amplicon production during each PCR cycle (i.e., in real time) as opposed to the endpoint detection.
- the real-time progress of the reaction can be viewed in some systems.
- Real-time PCR does not detect the size of the amplicon and thus does not allow the differentiation between DNA and cDNA amplification, however, it is not influenced by non-specific amplification unless SYBR Green is used.
- Real-time PCR quantitation eliminates post-PCR processing of PCR products. This helps to increase throughput and reduce the chances of carryover contamination.
- Real-time PCR also offers a wide dynamic range of up to 10 7 -fold.
- Dynamic range of any assay determines how much target concentration can vary and still be quantified.
- a wide dynamic range means that a wide range of ratios of target and normaliser can be assayed with equal sensitivity and specificity. It follows that the broader the dynamic range, the more accurate the quantitation.
- a real-time RT- PCR reaction reduces the time needed for measuring the amount of amplicon by providing for the visualization of the amplicon as the amplification process is progressing.
- the real-time PCR system is based on the detection and quantitation of a fluorescent reporter. This signal increases in direct proportion to the amount of PCR product in a reaction. By recording the amount of fluorescence emission at each cycle, it is possible to monitor the PCR reaction during exponential phase where the first significant increase in the amount of PCR product correlates to the initial amount of target template. The higher the starting copy number of the nucleic acid target, the sooner a significant increase in fluorescence is observed. A significant increase in fluorescence above the baseline value measured during the 3-15 cycles can indicate the detection of accumulated PCR product.
- a fixed fluorescence threshold is set significantly above the baseline that can be altered by the operator.
- the parameter CT threshold cycle is defined as the cycle number at which the fluorescence emission exceeds the fixed threshold.
- hydrolysis probes include TaqMan probes, molecular beacons and scorpions. They use the fluorogenic 5' exonuclease activity of Taq polymerase to measure the amount of target sequences in cDNA samples.
- TaqMan probes are designed to anneal to an internal region of a PCR product.
- Molecular beacons also contain fluorescent (FAM, TAMRA, TET, ROX) and quenching dyes (typically DABCYL) at either end but they are designed to adopt a hairpin structure while free in solution to bring the fluorescent dye and the quencher in close proximity for FRET to occur. They have two arms with complementary sequences that form a very stable hybrid or stem. The close proximity of the reporter and the quencher in this hairpin configuration suppresses reporter fluorescence. When the beacon hybridises to the target during the annealing step, the reporter dye is separated from the quencher and the reporter fluoresces (FRET does not occur). Molecular beacons remain intact during PCR and must rebind to target every cycle for fluorescence emission. This will correlate to the amount of PCR product available.
- All real-time PCR chemistries allow detection of multiple DNA species (multiplexing) by designing each probe/beacon with a spectrally unique fluor/quench pair as long as the platform is suitable for melting curve analysis if SYBR green is used.
- multiplexing the target(s) and endogenous control can be amplified in single tube.
- Scorpion probes sequence-specific priming and PCR product detection is achieved using a single oligonucleotide.
- the Scorpion probe maintains a stem-loop configuration in the unhybridised state.
- the fluorophore is attached to the 5' end and is quenched by a moiety coupled to the 3' end.
- the 3' portion of the stem also contains sequence that is complementary to the extension product of the primer. This sequence is linked to the 5' end of a specific primer via a non-amplifiable monomer.
- the specific probe sequence is able to bind to its complement within the extended amplicon thus opening up the hairpin loop. This prevents the fluorescence from being quenched and a signal is observed.
- SYBR- green I or ethidium bromide a non-sequence specific fluorescent intercalating agent
- SYBR green is a fluorogenic minor groove binding dye that exhibits little fluorescence when in solution but emits a strong fluorescent signal upon binding to double-stranded DNA.
- Disadvantages of SYBR green-based real-time PCR include the requirement for extensive optimisation.
- non-specific amplifications require follow-up assays (melting point curve or dissociation analysis) for amplicon identification.
- the threshold cycle or the CT value is the cycle at which a significant increase in ARn is first detected (for definition of ARn, see below).
- the threshold cycle is when the system begins to detect the increase in the signal associated with an exponential growth of PCR product during the log-linear phase. This phase provides the most useful information about the reaction (certainly more important than the end-point).
- the slope of the log-linear phase is a reflection of the amplification efficiency.
- the efficiency of the PCR should be 90 - 100% (3.6 > slope >3.1).
- a number of variables can affect the efficiency of the PCR. These factors include length of the amplicon, secondary structure and primer quality.
- the qRT-PCR should be further optimised or alternative amplicons designed.
- the slope to be an indicator of real amplification (rather than signal drift), there has to be an inflection point. This is the point on the growth curve when the log-linear phase begins. It also represents the greatest rate of change along the growth curve. (Signal drift is characterised by gradual increase or decrease in fluorescence without amplification of the product.)
- the important parameter for quantitation is the CT. The higher the initial amount of genomic DNA, the sooner accumulated product is detected in the PCR process, and the lower the CT value.
- the threshold should be placed above any baseline activity and within the exponential increase phase (which looks linear in the log transformation).
- CT cycle threshold
- Multiplex TaqMan assays can be performed using multiple dyes with distinct emission wavelengths.
- Available dyes for this purpose are FAM, TET, VIC and JOE (the most expensive).
- TAMRA is reserved as the quencher on the probe and ROX as the passive reference.
- FAM target
- VIC endogenous control
- JOE endogenous control
- VIC endogenous control
- the spectral compensation for the post run analysis should be turned on (on ABI 7700: Instrument/Diagnostics/Advanced Options/Miscellaneous). Activating spectral compensation improves dye spectral resolution.
- the disclosed methods can further utilize nested PCR.
- Nested PCR increases the specificity of DNA amplification, by reducing background due to non-specific amplification of DNA.
- Two sets of primers are being used in two successive PCRs. In the first reaction, one pair of primers is used to generate DNA products, which besides the intended target, may still consist of non-specifically amplified DNA fragments.
- the product(s) are then used in a second PCR with a set of primers whose binding sites are completely or partially different from and located 3' of each of the primers used in the first reaction.
- Nested PCR is often more successful in specifically amplifying long DNA fragments than conventional PCR, but it requires more detailed knowledge of the target sequences.
- Primers and Probes The disclosed methods and assays can use primers and probes.
- primers are a subset of probes which are capable of supporting some type of enzymatic manipulation and which can hybridize with a target nucleic acid such that the enzymatic manipulation can occur.
- a primer can be made from any combination of nucleotides or nucleotide derivatives or analogs available in the art which do not interfere with the enzymatic manipulation.
- probes are molecules capable of interacting with a target nucleic acid, typically in a sequence specific manner, for example through hybridization.
- the hybridization of nucleic acids is well understood in the art and discussed herein.
- a probe can be made from any combination of nucleotides or nucleotide derivatives or analogs available in the art.
- primers and probes which include the use of primers and probes, as well as, the disclosed primer panels all of which are capable of interacting with the disclosed nucleic acids such as ALK (SEQ ID NO: 1), BRAF, EGFR, KIT, or KRAS or their complement.
- ALK SEQ ID NO: 1
- BRAF BRAF
- EGFR EGFR
- KIT KRAS
- any of the primers or primer sets from Table 7-14 can be used in the disclosed primer panels or any of the methods and assays disclosed herein.
- the primers are used to support nucleic acid extension reactions, nucleic acid replication reactions, and/or nucleic acid amplification reactions.
- the primers will be capable of being extended in a sequence specific manner.
- Extension of a primer in a sequence specific manner includes any methods wherein the sequence and/or composition of the nucleic acid molecule to which the primer is hybridized or otherwise associated directs or influences the composition or sequence of the product produced by the extension of the primer.
- Extension of the primer in a sequence specific manner therefore includes, but is not limited to, PCR, DNA sequencing, DNA extension, DNA polymerization, RNA transcription, or reverse transcription. Techniques and conditions that amplify the primer in a sequence specific manner are disclosed.
- the primers are used for the DNA amplification reactions, such as PCR or direct sequencing.
- the primers can also be extended using non-enzymatic techniques, where for example, the nucleotides or oligonucleotides used to extend the primer are modified such that they will chemically react to extend the primer in a sequence specific manner.
- the disclosed primers hybridize with the disclosed nucleic acids or region of the nucleic acids or they hybridize with the complement of the nucleic acids or complement of a region of the nucleic acids.
- one or more primers can be used to create extension products from and templated by a first nucleic acid.
- the size of the primers or probes for interaction with the nucleic acids can be any size that supports the desired enzymatic manipulation of the primer, such as DNA amplification or the simple hybridization of the probe or primer.
- a typical primer or probe would be at least 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98,
- a primer or probe can be less than or equal to 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550,
- the primers for the nucleic acid of interest typically will be used to produce extension products and/or other replicated or amplified products that contain a region of the nucleic acid of interest.
- the size of the product can be such that the size can be accurately determined to within 3, or 2 or 1 nucleotides.
- the product can be, for example, at least 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550, 600, 650, 700, 750, 800, 850,
- the product can be, for example, less than or equal to 20, 21,
- multiplex PCR When multiple primer pairs are placed into a single reaction, this is referred to as “multiplex PCR.” It is understood and herein contemplated that any combination of two or more or three or more the forward and/or reverse primers disclosed herein can be used in the multiplex reaction.
- Fluorescent change probes and fluorescent change primers refer to all probes and primers that involve a change in fluorescence intensity or wavelength based on a change in the form or conformation of the probe or primer and nucleic acid to be detected, assayed or replicated.
- fluorescent change probes and primers include molecular beacons, Amplifluors, FRET probes, cleavable FRET probes, TaqMan probes, scorpion primers, fluorescent triplex oligos including but not limited to triplex molecular beacons or triplex FRET probes, fluorescent water-soluble conjugated polymers, PNA probes and QPNA probes.
- Fluorescent change probes and primers can be classified according to their structure and/or function.
- Fluorescent change probes include hairpin quenched probes, cleavage quenched probes, cleavage activated probes, and fluorescent activated probes.
- Fluorescent change primers include stem quenched primers and hairpin quenched primers.
- Hairpin quenched probes are probes that when not bound to a target sequence form a hairpin structure (and, typically, a loop) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched. When the probe binds to a target sequence, the stem is disrupted, the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases.
- hairpin quenched probes are molecular beacons, fluorescent triplex oligos, triplex molecular beacons, triplex FRET probes, and QPNA probes.
- Cleavage activated probes are probes where fluorescence is increased by cleavage of the probe.
- Cleavage activated probes can include a fluorescent label and a quenching moiety in proximity such that fluorescence from the label is quenched.
- the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases.
- TaqMan probes are an example of cleavage activated probes.
- Cleavage quenched probes are probes where fluorescence is decreased or altered by cleavage of the probe.
- Cleavage quenched probes can include an acceptor fluorescent label and a donor moiety such that, when the acceptor and donor are in proximity, fluorescence resonance energy transfer from the donor to the acceptor causes the acceptor to fluoresce.
- the probes are thus fluorescent, for example, when hybridized to a target sequence.
- the donor moiety is no longer in proximity to the acceptor fluorescent label and fluorescence from the acceptor decreases.
- the donor moiety is itself a fluorescent label, it can release energy as fluorescence (typically at a different wavelength than the fluorescence of the acceptor) when not in proximity to an acceptor.
- the overall effect would then be a reduction of acceptor fluorescence and an increase in donor fluorescence.
- Donor fluorescence in the case of cleavage quenched probes is equivalent to fluorescence generated by cleavage activated probes with the acceptor being the quenching moiety and the donor being the fluorescent label.
- Cleavable FRET (fluorescence resonance energy transfer) probes are an example of cleavage quenched probes.
- Fluorescent activated probes are probes or pairs of probes where fluorescence is increased or altered by hybridization of the probe to a target sequence.
- Fluorescent activated probes can include an acceptor fluorescent label and a donor moiety such that, when the acceptor and donor are in proximity (when the probes are hybridized to a target sequence), fluorescence resonance energy transfer from the donor to the acceptor causes the acceptor to fluoresce.
- Fluorescent activated probes are typically pairs of probes designed to hybridize to adjacent sequences such that the acceptor and donor are brought into proximity.
- Fluorescent activated probes can also be single probes containing both a donor and acceptor where, when the probe is not hybridized to a target sequence, the donor and acceptor are not in proximity but where the donor and acceptor are brought into proximity when the probe hybridized to a target sequence. This can be accomplished, for example, by placing the donor and acceptor on opposite ends of the probe and placing target complement sequences at each end of the probe where the target complement sequences are complementary to adjacent sequences in a target sequence. If the donor moiety of a fluorescent activated probe is itself a fluorescent label, it can release energy as fluorescence (typically at a different wavelength than the fluorescence of the acceptor) when not in proximity to an acceptor (that is, when the probes are not hybridized to the target sequence). When the probes hybridize to a target sequence, the overall effect would then be a reduction of donor fluorescence and an increase in acceptor fluorescence.
- FRET probes are an example of fluorescent activated probes.
- Stem quenched primers are primers that when not hybridized to a complementary sequence form a stem structure (either an intramolecular stem structure or an intermolecular stem structure) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched.
- stem quenched primers are used as primers for nucleic acid synthesis and thus become incorporated into the synthesized or amplified nucleic acid.
- Examples of stem quenched primers are peptide nucleic acid quenched primers and hairpin quenched primers.
- Peptide nucleic acid quenched primers are primers associated with a peptide nucleic acid quencher or a peptide nucleic acid fluor to form a stem structure.
- the primer contains a fluorescent label or a quenching moiety and is associated with either a peptide nucleic acid quencher or a peptide nucleic acid fluor, respectively. This puts the fluorescent label in proximity to the quenching moiety. When the primer is replicated, the peptide nucleic acid is displaced, thus allowing the fluorescent label to produce a fluorescent signal.
- Hairpin quenched primers are primers that when not hybridized to a complementary sequence form a hairpin structure (and, typically, a loop) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched. When the primer binds to a complementary sequence, the stem is disrupted; the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases. Hairpin quenched primers are typically used as primers for nucleic acid synthesis and thus become incorporated into the synthesized or amplified nucleic acid. Examples of hairpin quenched primers are Amplifluor primers and scorpion primers.
- Cleavage activated primers are similar to cleavage activated probes except that they are primers that are incorporated into replicated strands and are then subsequently cleaved. Labels
- labels can be directly incorporated into nucleotides and nucleic acids or can be coupled to detection molecules such as probes and primers.
- a label is any molecule that can be associated with a nucleotide or nucleic acid, directly or indirectly, and which results in a measurable, detectable signal, either directly or indirectly.
- labels for incorporation into nucleotides and nucleic acids or coupling to nucleic acid probes are known to those of skill in the art.
- Examples of labels suitable for use in the disclosed method are radioactive isotopes, fluorescent molecules, phosphorescent molecules, enzymes, antibodies, and ligands. Fluorescent labels, especially in the context of fluorescent change probes and primers, are useful for real-time detection of amplification.
- fluorescent labels include fluorescein isothiocyanate (FITC), 5,6-carboxymethyl fluorescein, Texas red, nitrobenz-2-oxa-l,3-diazol-4-yl ( BD), coumarin, dansyl chloride, rhodamine, amino-methyl coumarin (AMCA), Eosin, Erythrosin, BODIPY ® , CASCADE BLUE ® , OREGON GREEN ® , pyrene, lissamine, xanthenes, acridines, oxazines, phycoerythrin, macrocyclic chelates of lanthanide ions such as quantum dyeTM, fluorescent energy transfer dyes, such as thiazole orange-ethidium heterodimer, and the cyanine dyes Cy3, Cy3.5, Cy5, Cy5.5 and Cy7.
- FITC fluorescein isothiocyanate
- Texas red nitrobenz-2-oxa-l,3-
- Examples of other specific fluorescent labels include 3-Hydroxypyrene 5,8,10-Tri Sulfonic acid, 5-Hydroxy Tryptamine (5-HT), Acid Fuchsin, Alizarin Complexon, Alizarin Red, Allophycocyanin, Aminocoumarin, Anthroyl Stearate, Astrazon Brilliant Red 4G, Astrazon Orange R, Astrazon Red 6B, Astrazon Yellow 7 GLL, Atabrine, Auramine, Aurophosphine, Aurophosphine G, BAO 9 (Bisaminophenyloxadiazole), BCECF, BerberineSulphate, Bisbenzamide, Blancophor FFG Solution, Blancophor SV, Bodipy Fl, Brilliant Sulpho flavin FF, Calcien Blue, Calcium Green, Calcofluor RW Solution, Calcofluor White, Calcophor White ABT Solution, Calcophor White Standard Solution, Carbostyryl, Cascade Yellow, Catecholamine, Chinacrine, Coriphosphine O, Coumarin
- Leucophor WS LissamineRhodamine B200 (RD200), Lucifer Yellow CH, Lucifer Yellow VS, Magdala Red, Marina Blue, Maxilon Brilliant Flavin 10 GFF, Maxilon Brilliant Flavin 8 GFF, MPS (Methyl Green PyronineStilbene), Mithramycin, NBD Amine,
- Nitrobenzoxadidole Noradrenaline, Nuclear Fast Red, Nuclear Yellow, Nylosan Brilliant Flavin E8G, Oxadiazole, Pacific Blue, Pararosaniline (Feulgen), Phorwite AR Solution, Phorwite BKL, Phorwite Rev, Phorwite RPA, Phosphine 3R, Phthalocyanine,
- Phycoerythrin R Phycoerythrin B, PolyazaindacenePontochrome Blue Black, Porphyrin, Primuline, Procion Yellow, Pyronine, Pyronine B, Pyrozal Brilliant Flavin 7GF, Quinacrine Mustard, Rhodamine 123, Rhodamine 5 GLD, Rhodamine 6G, Rhodamine B, Rhodamine B 200, Rhodamine B Extra, Rhodamine BB, Rhodamine BG, Rhodamine WT, Serotonin, Sevron Brilliant Red 2B, Sevron Brilliant Red 4G, Sevron Brilliant Red B, Sevron Orange, Sevron Yellow L, SITS (Primuline), SITS (Stilbenelsothiosulphonic acid), Stilbene, Snarf 1, sulphoRhodamine B Can C, SulphoRhodamine G Extra, Tetracycline, Thiazine Red R, Thioflavin S, Thioflavin TCN, Thi
- the absorption and emission maxima, respectively, for some of these fluors are: FITC (490 nm; 520 nm), Cy3 (554 nm; 568 nm), Cy3.5 (581 nm; 588 nm), Cy5 (652 nm: 672 nm), Cy5.5 (682 nm; 703 nm) and Cy7 (755 nm; 778 nm), thus allowing their simultaneous detection.
- fluorescein dyes include 6-carboxyfluorescein (6-FAM), 2',4',1,4,-tetrachlorofluorescein (TET), 2',4',5',7',1,4-hexachlorofluorescein (HEX), 2',7'-dimethoxy-4', 5'-dichloro-6-carboxyrhodamine (JOE), 2'-chloro-5'-fluoro-7',8'- fused phenyl- l,4-dichloro-6-carboxyfluorescein (NED), and 2'-chloro-7'-phenyl-l,4- dichloro-6-carboxyfluorescein (VIC).
- Fluorescent labels can be obtained from a variety of commercial sources, including Amersham Pharmacia Biotech, Piscataway, NJ; Molecular Probes, Eugene, OR; and Research Organics, Cleveland, Ohio.
- Additional labels of interest include those that provide for signal only when the probe with which they are associated is specifically bound to a target molecule, where such labels include: "molecular beacons" as described in Tyagi& Kramer, Nature Biotechnology (1996) 14:303 and EP 0 070 685 B l.
- Other labels of interest include those described in U.S. Pat. No. 5,563,037 which is incorporated herein by reference.
- Labeled nucleotides are a form of label that can be directly incorporated into the amplification products during synthesis.
- labels that can be incorporated into amplified nucleic acids include nucleotide analogs such as BrdUrd, aminoallyldeoxyuridine, 5-methylcytosine, bromouridine, and nucleotides modified with biotin or with suitable haptens such as digoxygenin.
- Suitable fluorescence-labeled nucleotides are Fluorescein- isothiocyanate-dUTP, Cyanine-3-dUTP and Cyanine-5-dUTP.
- nucleotide analog label for DNA is BrdUrd (bromodeoxyuridine, BrdUrd, BrdU, BUdR, Sigma- Aldrich Co).
- nucleotide analogs for incorporation of label into DNA are AA-dUTP (aminoallyl-deoxyuridine triphosphate, Sigma-Aldrich Co.), and 5-methyl-dCTP (Roche Molecular Biochemicals).
- AA-dUTP aminoallyl-deoxyuridine triphosphate
- 5-methyl-dCTP Roche Molecular Biochemicals
- nucleotide analog for incorporation of label into RNA is biotin- 16-UTP (biotin- 16-uridine-5'-triphosphate, Roche Molecular Biochemicals). Fluorescein, Cy3, and Cy5 can be linked to dUTP for direct labeling.
- Cy3.5 and Cy7 are available as avidin or anti-digoxygenin conjugates for secondary detection of biotin- or digoxygenin-labeled probes.
- Biotin can be detected using streptavidin-alkaline phosphatase conjugate (Tropix, Inc.), which is bound to the biotin and subsequently detected by chemiluminescence of suitable substrates (for example, chemiluminescent substrate CSPD: disodium, 3-(4-methoxyspiro-[l,2,- dioxetane-3-2'-(5'-chloro)tricyclo [3.3.1.1 3 ' 7 ]decane]-4-yl) phenyl phosphate; Tropix, Inc.).
- suitable substrates for example, chemiluminescent substrate CSPD: disodium, 3-(4-methoxyspiro-[l,2,- dioxetane-3-2'-(5'-chloro)tricyclo [3.3.1.1 3 ' 7 ]decane]-4-yl
- Labels can also be enzymes, such as alkaline phosphatase, soybean peroxidase, horseradish peroxidase and polymerases, that can be detected, for example, with chemical signal amplification or by using a substrate to the enzyme which produces light (for example, a chemiluminescent 1 ,2-dioxetane substrate) or fluorescent signal.
- enzymes such as alkaline phosphatase, soybean peroxidase, horseradish peroxidase and polymerases
- a substrate to the enzyme which produces light for example, a chemiluminescent 1 ,2-dioxetane substrate
- fluorescent signal for example, a chemiluminescent 1 ,2-dioxetane substrate
- Molecules that combine two or more of these labels are also considered labels. Any of the known labels can be used with the disclosed probes, tags, and method to label and detect nucleic acid amplified using the disclosed method. Methods for detecting and measuring signals generated by labels are also known to those of skill in the art. For example, radioactive isotopes can be detected by scintillation counting or direct visualization; fluorescent molecules can be detected with fluorescent spectrophotometers; phosphorescent molecules can be detected with a spectrophotometer or directly visualized with a camera; enzymes can be detected by detection or visualization of the product of a reaction catalyzed by the enzyme; antibodies can be detected by detecting a secondary label coupled to the antibody. As used herein, detection molecules are molecules which interact with amplified nucleic acid and to which one or more labels are coupled.
- the disclosed methods, assays, and primer panels can be used to diagnose any disease where uncontrolled cellular proliferation occurs herein referred to as "cancer".
- cancer A non-limiting list of different types of ALK related cancers is as follows: lymphomas (Hodgkins and non-Hodgkins), leukemias, carcinomas, carcinomas of solid tissues, squamous cell carcinomas, adenocarcinomas, sarcomas, gliomas, high grade gliomas, blastomas, neuroblastomas, plasmacytomas, histiocytomas, melanomas, adenomas, hypoxic tumours, myelomas, AIDS-related lymphomas or sarcomas, metastatic cancers, or cancers in general.
- lymphomas Hodgkins and non-Hodgkins
- leukemias carcinomas, carcinomas of solid tissues
- squamous cell carcinomas adenocarcinomas
- sarcomas gliomas
- lymphoma B cell lymphoma (including diffuse large B-cell lymphoma), B-cell plasmablastic/immunoblastic lymphomas, T cell lymphoma (including T- or null-cell lymphomas), mycosis fungoides, Hodgkin's Disease, myeloid leukemia, bladder cancer, brain cancer, nervous system cancer, head and neck cancer, squamous cell carcinoma of head and neck, kidney cancer, lung cancers such as small cell lung cancer and non-small cell lung cancer, neuroblastoma/glioblastoma, , anaplastic large-cell lymphoma (ALCL), inflammatory myofibroblastic tumors, ovarian cancer, pancreatic cancer, prostate cancer, skin cancer, liver cancer, melanoma, malignant histiocytosis, squamous cell carcinomas of the mouth, throat, larynx, and lung, colon cancer, cervical cancer, cervical
- the disclosed method and compositions make use of various nucleic acids.
- any nucleic acid can be used in the disclosed method.
- the disclosed nucleic acids of interest and the disclosed reference nucleic acids can be chosen based on the desired analysis and information that is to be obtained or assessed.
- the disclosed methods also produce new and altered nucleic acids. The nature and structure of such nucleic acids will be established by the manner in which they are produced and manipulated in the methods.
- extension products and hybridizing nucleic acids are produced in the disclosed methods.
- hybridizing nucleic acids are hybrids of extension products and the second nucleic acid.
- a nucleic acid of interest can be any nucleic acid to which the determination of the presence or absence of nucleotide variation is desired.
- the nucleic acid of interest can comprise a sequence that corresponds to the wild-type sequence of the reference nucleic acid. It is further disclosed herein that the disclosed methods can be performed where the first nucleic acid is a reference nucleic acid and the second nucleic acid is a nucleic acid of interest or where the first nucleic acid is the nucleic acid of interest and the second nucleic acid is the reference nucleic acid.
- a reference nucleic acid can be any nucleic acid against which a nucleic acid of interest is to be compared.
- the reference nucleic acid has a known sequence (and/or is known to have a sequence of interest as a reference).
- the reference sequence has a known or suspected close relationship to the nucleic acid of interest.
- the reference sequence can be usefully chosen to be a sequence that is a homolog or close match to the nucleic acid of interest, such as a nucleic acid derived from the same gene or genetic element from the same or a related organism or individual.
- the reference nucleic acid can comprise a wild-type sequence or alternatively can comprise a known mutation including, for example, a mutation the presence or absence of which is associated with a disease or resistance to therapeutic treatment.
- the disclosed methods can be used to detect or diagnose the presence of known mutations in a nucleic acid of interest by comparing the nucleic acid of interest to a reference nucleic acid that comprises a wild-type sequence (i.e., is known not to possess the mutation) and examining for the presence or absence of variation in the nucleic acid of interest, where the absence of variation would indicate the absence of a mutation.
- the reference nucleic acid can possess a known mutation.
- the disclosed methods can be used to detect susceptibility for a disease or condition by comparing the nucleic acid of interest to a reference nucleic acid comprising a known mutation that indicates susceptibility for a disease and examining for the presence or absence of the mutation, wherein the presence of the mutation indicates a disease.
- nucleotide variation refers to any change or difference in the nucleotide sequence of a nucleic acid of interest relative to the nucleotide sequence of a reference nucleic acid.
- a nucleotide variation is said to occur when the sequences between the reference nucleic acid and the nucleic acid of interest (or its complement, as appropriate in context) differ.
- a substitution of an adenine (A) to a guanine (G) at a particular position in a nucleic acid would be a nucleotide variation provided the reference nucleic acid comprised an A at the corresponding position.
- nucleic acid determines whether or not a sequence is wild-type.
- a nucleic acid with a known mutation is used as the reference nucleic acid
- a nucleic acid not possessing the mutation would be considered to possess a nucleotide variation (relative to the reference nucleic acid).
- nucleotide for a nucleotide. It is understood and contemplated herein that where reference is made to a type of base, this refers a base that in a nucleotide in a nucleic acid strand is capable of hybridizing (binding) to a defined set of one or more of the canonical bases.
- nuclease-resistant nucleotides can be, for example, guanine (G), thymine (T), and cytosine (C).
- G guanine
- T thymine
- C cytosine
- modified or alternative base can be used in the disclosed methods and compositions, generally limited only by the capabilities of the enzymes used to use such bases.
- Many modified and alternative nucleotides and bases are known, some of which are described below and elsewhere herein.
- the type of base that such modified and alternative bases represent can be determined by the pattern of base pairing for that base as described herein. Thus for example, if the modified nucleotide was adenine, any analog, derivative, modified, or variant base that based pairs primarily with thymine would be considered the same type of base as adenine. In other words, so long as the analog, derivative, modified, or variant has the same pattern of base pairing as another base, it can be considered the same type of base. Modifications can made to the sugar or phosphate groups of a nucleotide. Generally such modifications will not change the base pairing pattern of the base.
- the base pairing pattern of a nucleotide in a nucleic acid strand determines the type of base of the base in the nucleotide.
- Modified nucleotides to be incorporated into extension products and to be selectively removed by the disclosed agents in the disclosed methods can be any modified nucleotide that functions as needed in the disclosed method as is described elsewhere herein. Modified nucleotides can also be produced in existing nucleic acid strands, such as extension products, by, for example, chemical modification, enzymatic modification, or a combination.
- nuclease-resistant nucleotides Many types of nuclease-resistant nucleotides are known and can be used in the disclosed methods.
- nucleotides have modified phosphate groups and/or modified sugar groups can be resistant to one or more nucleases.
- Nuclease-resistance is defined herein as resistance to removal from a nucleic acid by any one or more nucleases.
- nuclease resistance of a particular nucleotide can be defined in terms of a relevant nuclease.
- the nuclease-resistant nucleotides need only be resistant to that particular nuclease.
- useful nuclease-resistant nucleotides include thio-modified nucleotides and borano-modified nucleotides.
- nucleotide is a molecule that contains a base moiety, a sugar moiety and a phosphate moiety. Nucleotides can be linked together through their phosphate moieties and sugar moieties creating an internucleoside linkage.
- the base moiety of a nucleotide can be adenine-9-yl (adenine, A), cytosine- 1-yl (cytosine, C), guanine-9-yl (guanine, G), uracil- 1- yl (uracil, U), and thymin-l-yl (thymine, T).
- the sugar moiety of a nucleotide is a ribose or a deoxyribose.
- the phosphate moiety of a nucleotide is pentavalent phosphate.
- a non- limiting example of a nucleotide would be 3'-AMP (3'-adenosine monophosphate) or 5'- GMP (5'-guanosine monophosphate).
- a nucleotide analog is a nucleotide which contains some type of modification to either the base, sugar, or phosphate moieties. Modifications to the base moiety would include natural and synthetic modifications of A, C, G, and T/U as well as different purine or pyrimidine bases, such as uracil-5-yl ( ⁇ ), hypoxanthin-9-yl (inosine, I), and 2- aminoadenin-9-yl.
- a modified base includes but is not limited to 5-methylcytosine (5-me- C), 5-hydroxymethyl cytosine, xanthine, hypoxanthine, 2-aminoadenine, 6-methyl and other alkyl derivatives of adenine and guanine, 2-propyl and other alkyl derivatives of adenine and guanine, 2-thiouracil, 2-thiothymine and 2-thiocytosine, 5-halouracil and cytosine, 5- propynyl uracil and cytosine, 6-azo uracil, cytosine and thymine, 5 -uracil (pseudouracil), 4- thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl and other 8-substituted adenines and guanines, 5-halo particularly 5-bromo, 5-trifluoromethyl and other 5-substituted uracils and
- nucleotide analogs such as 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and 0-6 substituted purines, including 2-aminopropyladenine, 5-propynyluracil and 5- propynylcytosine. 5-methylcytosine can increase the stability of duplex formation.
- time base modifications can be combined with for example a sugar modification, such as 2'- O-methoxyethyl, to achieve unique properties such as increased duplex stability.
- Nucleotide analogs can also include modifications of the sugar moiety.
- Modifications to the sugar moiety would include natural modifications of the ribose and deoxy ribose as well as synthetic modifications.
- Sugar modifications include but are not limited to the following modifications at the 2' position: OH; F; 0-, S-, or N-alkyl; 0-, S-, or N-alkenyl; 0-, S-or N-alkynyl; or O-alkyl-O-alkyl, wherein the alkyl, alkenyl and alkynyl may be substituted or unsubstituted CI to CIO, alkyl or C2 to CIO alkenyl and alkynyl.
- 2' sugar modifications also include but are not limited to -0[(CH2)n 0]m CH3, - 0(CH2)n 0CH3, -0(CH2)n NH2, -0(CH2)n CH3, -0(CH2)n -0NH2, and - 0(CH2)nON[(CH2)n CH3)]2, where n and m are from 1 to about 10.
- modifications at the 2' position include but are not limited to: CI to CIO lower alkyl, substituted lower alkyl, alkaryl, aralkyl, O-alkaryl or O-aralkyl, SH, SCH3, OCN, CI, Br, CN, CF3, OCF3, SOCH3, S02 CH3, ON02, N02, N3, NH2, heterocycloalkyl, heterocycloalkaryl, aminoalkylamino, polyalkylamino, substituted silyl, an RNA cleaving group, a reporter group, an intercalator, a group for improving the pharmacokinetic properties of an oligonucleotide, or a group for improving the pharmacodynamic properties of an oligonucleotide, and other substituents having similar properties. Similar
- modifications may also be made at other positions on the sugar, particularly the 3' position of the sugar on the 3' terminal nucleotide or in 2'-5' linked oligonucleotides and the 5' position of 5' terminal nucleotide. Modified sugars would also include those that contain modifications at the bridging ring oxygen, such as CH2 and S. Nucleotide sugar analogs may also have sugar mimetics such as cyclobutyl moieties in place of the pentofuranosyl sugar.
- Nucleotide analogs can also be modified at the phosphate moiety.
- Modified phosphate moieties include but are not limited to those that can be modified so that the linkage between two nucleotides contains a phosphorothioate, chiral phosphorothioate, phosphorodithioate, phosphotriester, aminoalkylphosphotriester, methyl and other alkyl phosphonates including 3'-alkylene phosphonate and chiral phosphonates, phosphinates, phosphoramidates including 3 '-amino phosphoramidate and aminoalkylphosphoramidates, thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, and boranophosphates.
- these phosphate or modified phosphate linkage between two nucleotides can be through a 3'-5' linkage or a 2'-5' linkage, and the linkage can contain inverted polarity such as 3'-5' to 5'-3' or 2'-5' to 5'-2'.
- Various salts, mixed salts and free acid forms are also included.
- nucleotide analogs need only contain a single modification, but may also contain multiple modifications within one of the moieties or between different moieties.
- Nucleotide substitutes are molecules having similar functional properties to nucleotides, but which do not contain a phosphate moiety, such as peptide nucleic acid (PNA). Nucleotide substitutes are molecules that will recognize nucleic acids in a Watson- Crick or Hoogsteen manner, but which are linked together through a moiety other than a phosphate moiety. Nucleotide substitutes are able to conform to a double helix type structure when interacting with the appropriate target nucleic acid.
- PNA peptide nucleic acid
- Nucleotide substitutes are nucleotides or nucleotide analogs that have had the phosphate moiety and/or sugar moieties replaced. Nucleotide substitutes do not contain a standard phosphorus atom. Substitutes for the phosphate can be for example, short chain alkyl or cycloalkylinternucleoside linkages, mixed heteroatom and alkyl or
- cycloalkylinternucleoside linkages or one or more short chain heteroatomic or heterocyclic internucleoside linkages.
- These include those having morpholino linkages (formed in part from the sugar portion of a nucleoside); siloxane backbones; sulfide, sulfoxide and sulfone backbones; formacetyl and thioformacetyl backbones; methylene formacetyl and thioformacetyl backbones; alkene containing backbones; sulfamate backbones;
- methyleneimino and methylenehydrazino backbones sulfonate and sulfonamide backbones; amide backbones; and others having mixed N, O, S and CH2 component parts.
- PNA aminoethylglycine
- Such conjugates include but are not limited to lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g., hexyl-S-tritylthiol, a thiocholesterol, an aliphatic chain, e.g., dodecandiol or undecyl residues, a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethylammonium l,2-di-0-hexadecyl-rac-glycero-3-H-phosphonate, a polyamine or a polyethylene glycol chain, or adamantane acetic acid, a palmityl moiety, or an lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g., hexyl-S-tritylthiol, a thiocholesterol, an ali
- octadecylamine or hexylamino-carbonyl-oxycholesterol moiety octadecylamine or hexylamino-carbonyl-oxycholesterol moiety.
- a Watson-Crick interaction is at least one interaction with the Watson-Crick face of a nucleotide, nucleotide analog, or nucleotide substitute.
- the Watson-Crick face of a nucleotide, nucleotide analog, or nucleotide substitute includes the C2, Nl, and C6 positions of a purine based nucleotide, nucleotide analog, or nucleotide substitute and the C2, N3, C4 positions of a pyrimidine based nucleotide, nucleotide analog, or nucleotide substitute.
- a Hoogsteen interaction is the interaction that takes place on the Hoogsteen face of a nucleotide or nucleotide analog, which is exposed in the major groove of duplex DNA.
- the Hoogsteen face includes the N7 position and reactive groups (NH2 or O) at the C6 position of purine nucleotides.
- hybridization typically means a sequence driven interaction between at least two nucleic acid molecules, such as a primer or a probe and a gene.
- Sequence driven interaction means an interaction that occurs between two nucleotides or nucleotide analogs or nucleotide derivatives in a nucleotide specific manner. For example, G interacting with C or A interacting with T are sequence driven interactions. Typically sequence driven interactions occur on the Watson-Crick face or Hoogsteen face of the nucleotide.
- the hybridization of two nucleic acids is affected by a number of conditions and parameters known to those of skill in the art. For example, the salt concentrations, pH, and temperature of the reaction all affect whether two nucleic acid molecules will hybridize. Parameters for selective hybridization between two nucleic acid molecules are well known to those of skill in the art. For example, in some embodiments selective
- hybridization conditions can be defined as stringent hybridization conditions.
- stringency of hybridization is controlled by both temperature and salt concentration of either or both of the hybridization and washing steps.
- hybridization to achieve selective hybridization may involve hybridization in high ionic strength solution (6X SSC or 6X SSPE) at a temperature that is about 12-25°C below the Tm (the melting temperature at which half of the molecules dissociate from their hybridization partners) followed by washing at a combination of temperature and salt concentration chosen so that the washing temperature is about 5°C to 20°C below the Tm.
- Tm the melting temperature at which half of the molecules dissociate from their hybridization partners
- the temperature and salt conditions are readily determined empirically in preliminary experiments in which samples of reference DNA immobilized on filters are hybridized to a labeled nucleic acid of interest and then washed under conditions of different stringencies.
- Hybridization temperatures are typically higher for DNA-RNA and RNA-RNA
- a preferable stringent hybridization condition for a DNA:DNA hybridization can be at about 68°C (in aqueous solution) in 6X SSC or 6X SSPE followed by washing at 68°C.
- Stringency of hybridization and washing if desired, can be reduced accordingly as the degree of complementarity desired is decreased, and further, depending upon the G-C or A-T richness of any area wherein variability is searched for.
- stringency of hybridization and washing if desired, can be increased accordingly as homology desired is increased, and further, depending upon the G-C or A-T richness of any area wherein high homology is desired, all as known in the art.
- selective hybridization conditions would be when at least about, 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100 percent of the limiting nucleic acid is bound to the non-limiting nucleic acid.
- the non-limiting primer is in for example, 10 or 100 or 1000 fold excess.
- This type of assay can be performed at under conditions where both the limiting and non-limiting primer are for example, 10 fold or 100 fold or 1000 fold below their ka, or where only one of the nucleic acid molecules is 10 fold or 100 fold or 1000 fold or where one or both nucleic acid molecules are above their ka.
- selective hybridization conditions would be when at least about, 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100 percent of the primer is enzymatically manipulated under conditions which promote the enzymatic manipulation, for example if the enzymatic manipulation is DNA extension, then selective hybridization conditions would be when at least about 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90,
- composition or method meets any one of these criteria for determining hybridization either collectively or singly it is a composition or method that is disclosed herein.
- kits Disclosed herein are kits that are drawn to reagents that can be used in practicing the methods disclosed herein.
- the kits can include any reagent or combination of reagents discussed herein or that would be understood to be required or beneficial in the practice of the disclosed methods.
- the kits could include one or more primers from Tables 7-14 disclosed herein to perform the extension, replication and amplification reactions discussed in certain embodiments of the methods, as well as the buffers and enzymes required to use the primers as intended.
- the kit can also include other necessary reagents to perform any of the next generation sequencing techniques disclosed herein.
- the disclosed kits can include one or more of the probes listed in Table 15 in addition to or instead of one or more primers from Table 7-14.
- kits can comprise at least one primer set to detect the presence of nucleic acid variation in each ⁇ , BRAF, KRAS, ALK, and EGFR.
- the kits can comprise at least one primer or primer set for sequencing at least one of each of the KIT, BRAF, KRAS, ALK, and EGFR exons of Tables 1.
- the kits can comprise at least one primer or primer set from each of Tables 7-14.
- the kit can comprise a primer or primer set that will detect one or more of the specific mutations listed in Tables 2-6.
- kits for performing a NGS sequencing reaction on a tissue sample to detect the presence of a mutation conferring kinase inhibitor resistance comprising at least one or more primer or primer set from each of Table 7-14.
- kits for performing a NGS sequencing reaction on a tissue sample to detect the presence of a mutation conferring kinase inhibitor resistance comprising at least one or more primer or primer set capable of specifically hybridizing an amplifying any of the mutant sequences of KIT, BRAF, KRAS, ALK, and EGFR present in Tables 2-6.
- kits can include such other reagents and material for performing the disclosed methods such as enzymes (e.g., polymerases), buffers, sterile water, and/or reaction tubes. Additionally the kits can also include modified nucleotides, nuclease-resistant nucleotides, and or labeled nucleotides. Additionally, the disclosed kits can include instructions for performing the methods disclosed herein and software for enable the calculation of the presence of a kinase inhibitor mutation (i.e., a mutation in KIT, BRAF, KRAS, EGFR, and/or ALK).
- a kinase inhibitor mutation i.e., a mutation in KIT, BRAF, KRAS, EGFR, and/or ALK.
- compositions disclosed herein and the compositions necessary to perform the disclosed methods can be made using any method known to those of skill in the art for that particular reagent or compound unless otherwise specifically noted.
- the disclosed nucleic acids such as, the oligonucleotides to be used as primers can be made using standard chemical synthesis methods or can be produced using enzymatic methods or any other known method. Such methods can range from standard enzymatic digestion followed by nucleotide fragment isolation to purely synthetic methods, for example, by the cyanoethylphosphoramidite method using a Milligen or Beckman System lPlus DNA synthesizer (for example, Model 8700 automated synthesizer of Milligen- Biosearch, Burlington, MA or ABI Model 380B).
- a Milligen or Beckman System lPlus DNA synthesizer for example, Model 8700 automated synthesizer of Milligen- Biosearch, Burlington, MA or ABI Model 380B.
- Applicants have designed and developed a next generation sequencing panel to amplify and sequence one or more exons within ALK and other oncogenes implicated in driving tumorigenesis in the presence of crizotinib (i.e. ALK, BRAF, EGFR, KIT and K- RAS. See Table 1 for an overarching description of the exons targeted for sequencing in the panel and Tables 2-6 for a more detailed list of each mutation detected by the Insight ALK resistance ZDTM panel. Primer sequences used to amplify each gene segment are depicted in Tables 7-14.
- Polymerase chain reaction is used to create amplicons that span the exonic regions mentioned above.
- the design described here is agnostic to the NGS platform used to perform the actual sequencing, and thus multiple PCR strategies can match the size of the PCR fragments to the read-length of the sequencing platform being employed.
- the PCR amplification can be done in a single-tube as a multiple reaction where all targets are covered at once. In the case of low coverage or ambiguous results, a single-plex PCR can be performed as a confirmatory step to ensure accurate mutation calling. This is also true in the case of highly-degraded samples where the template DNA has fragmented and large- amplicons cannot be extracted from the DNA that remains.
- each PCR reaction consist of 95°C 15-min heat denaturation phase followed by 40 cycles of denaturation at 95°C for 15 sec and 55°C annealing for 30 sec and 72°C extension for 1 min and finally a 72°C final extension step for 5 minutes.
- the Insight ALK resistance IDTM is designed to be able to produce fragments as short as 150 bases to as high as 5kb.
- each amplicon can be matched to the output of long-read and middle-read technologies (150-1000 bases) or have large enough fragments (5kb) that can be effectively sheared, either sonically or enzymatically, to be compatible with short-read sequencers ( ⁇ 150 bases).
- the ALK resistance IDTM takes advantage of the very high-throughput offered by modern sequencers to cover the regions of interest at very high coverage (depth > 5,000X) and thus enable the detection of rare variants only present in the sample at a frequency of 1% or less.
- the sequence reads that are generated can be compared to a reference sequence examined for the presence of any of the mutations listed in Tables 2-6.
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Description
METHODS AND COMPOSITIONS RELATING TO NEXT GENERATION SEQUENCING FOR GENETIC TESTING IN ALATRELATED CANCERS
BACKGROUND
Mutations of anaplastic lymphoma kinase (ALK) gene are thought to be involved in the development of subsets of numerous cancers including i) non-small cell lung carcinoma (NSCLC); ii) diffuse large B-cell lymphoma; iii) esophageal squamous cell carcinoma; iv) anaplastic large-cell lymphoma (ALCL); v) neuroblastoma (a childhood cancer that arises from the developing peripheral nervous system); and vi) the sarcomas known as inflammatory myofibroblastic tumors (IMTs). Patient outcomes with many of these malignancies are poor, due in part to the late detection of the cancers because of the lack of efficient clinical diagnostic methods. Early detection and diagnosis oiALK- mediated cancers dramatically increases survival rates within the patient population; as an example, early detection of ALK-positb/Q anaplastic large-cell lymphoma can result in survival rates of up to 83% whereas late detection is associated in some instances with survival of only 50% of the patient population.
The critical role of deregulated ALK signaling as a driver of subsets of NSCLC, ALCL, and other ALK-dspsndsnt cancer types has been validated in clinical trials, with dramatic anti-tumor efficacy observed in response to the ALK small-molecule inhibitor crizotinib (XALKORI®, Pfizer; approved by the US FDA in August 201 1).
Unfortunately, despite the marked anti-tumor responses to XALKORI® seen in patients with ALK-drb/sn tumors, most patients eventually experience progression of their cancer as a consequence of treatment resistance. For example, the median duration of
progression-free survival in patients with ALK-positb/Q NSCLC treated with Xalkori is only about 10 months. What is needed are assays the can efficiently and reliably detect kinase inhibitor-resistance mutations and therefore predict which members of a patient population is likely to develop kinase inhibitor resistance. Additionally as new
generations of small-molecule inhibitors are developed, also need is a clinically applicable diagnostic test to identify resistance mutations in the ALK kinase domain and therefore to guide the rational use of these small-molecule inhibitors for the treatment of
ALK-drwen cancers that have lost their responsiveness to -generation inhibitor therapy. Moreover, once several ALK small-molecule inhibitors are approved for clinical use, optimal management of patients with
tumors will require screening for de novo inhibitor resistance mutations by healthcare providers treating newly diagnosed patients in order to assess their inhibitor sensitivity and choose the best ALK inhibitor drug(s) for personalized therapy.
BRIEF SUMMARY
The methods, assays, and compositions disclosed herein relate to the field of detection or diagnosis of mutations that confer resistance to kinase inhibitors of a disease or condition such as cancer. In one aspect, the kinase inhibitors or ALK kinase inhibitors. Also disclosed herein are methods and assays for assessing the susceptibility or risk for developing resistance to an inhibitor, wherein the disease or condition is a cancer associated with expression of the ALK gene. It is understood and herein contemplated that the methods disclosed herein allow for rapid and sensitive detection of nucleic acid expression of mutations in ALK.
In another aspect, disclosed herein are kinase inhibitor resistance panels comprising one or more primer sets from each of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
In accordance with the purpose(s) of this invention, as embodied and broadly described herein, this invention, in one aspect, relates to an ALK kinase inhibitor resistance panel. In particular, the invention, in one aspect, relates to an ALK kinase inhibitor resistance panel comprising one or more primer sets for detecting the presence of a mutation in a gene that will confer resistance to the ALK kinase inhibitor.
Additional advantages of the disclosed methods and compositions will be set forth in part in the description which follows, and in part will be understood from the description, or may be learned by practice of the disclosed method and compositions. The advantages of the disclosed methods and compositions will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims. It is to be
understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed.
BRIEF DESRIPTION OF THE DRAWINGS
Figure 1 shows XALKORI®-resistance mutations identified in patient specimens.
The figure depicts the XALKORI®-resistance mutations in the ALK kinase domain identified to date in patient cancer specimens.
DETAILED DESCRIPTION
Before the present compounds, compositions, articles, devices, and/or methods are disclosed and described, it is to be understood that they are not limited to specific synthetic methods or specific recombinant biotechnology methods unless otherwise specified, or to particular reagents unless otherwise specified, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting.
As used in the specification and the appended claims, the singular forms "a," "an" and "the" include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to "a pharmaceutical carrier" includes mixtures of two or more such carriers, and the like.
Ranges can be expressed herein as from "about" one particular value, and/or to
"about" another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent "about," it will be understood that the particular value forms another embodiment. It will be further understood that the endpoints of each of the ranges are significant both in relation to the other endpoint, and independently of the other endpoint. It is also understood that there are a number of values disclosed herein, and that each value is also herein disclosed as "about" that particular value in addition to the value itself. For example, if the value "10" is
disclosed, then "about 10" is also disclosed. It is also understood that when a value is disclosed that "less than or equal to" the value, "greater than or equal to the value" and possible ranges between values are also disclosed, as appropriately understood by the skilled artisan. For example, if the value "10" is disclosed the "less than or equal to 10"as well as "greater than or equal to 10" is also disclosed. It is also understood that the throughout the application, data is provided in a number of different formats, and that this data, represents endpoints and starting points, and ranges for any combination of the data points. For example, if a particular data point "10" and a particular data point 15 are disclosed, it is understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15 are considered disclosed as well as between 10 and 15.
In this specification and in the claims which follow, reference will be made to a number of terms which shall be defined to have the following meanings:
"Optional" or "optionally" means that the subsequently described event or circumstance may or may not occur, and that the description includes instances where said event or circumstance occurs and instances where it does not.
An "increase" can refer to any change that results in a larger amount of a composition or compound, such as an amplification product relative to a control. Thus, for example, an increase in the amount in amplification products can include but is not limited to a 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 150%, 200%, 250%, 300%, 350%, 400%, 450%, 500%, 550%, 600%, 700%, 800%, 900%, 1000%, 1500%, 2000%, 2500%, 3000%, 3500%, 4000%, 4500%, or 5000% increase. It is further contemplated herein that the detection an increase in expression or abundance of a DNA, mRNA, or protein relative to a control necessarily includes detection of the presence of the DNA, mRNA, or protein in situations where the DNA, mRNA, or protein is not present in the control.
"Obtaining a tissue sample" or "obtain a tissue sample" means to collect a sample of tissue either from a party having previously harvested the tissue or harvesting directly from a subject. It is understood and herein contemplated that tissue samples obtained directly
from the subject can be obtained by any means known in the art including invasive and noninvasive techniques. It is also understood that methods of measurement can be direct or indirect. Examples of methods of obtaining or measuring a tissue sample can include but are not limited to tissue biopsy, tissue lavage, blood collection, aspiration, tissue swab, spinal tap, magnetic resonance imaging (MRI), Computed Tomography (CT) scan, Positron Emission Tomography (PET) scan, and X-ray (with and without contrast media). It is further understood that a "tissue" can include, but is not limited to any grouping of one or more cells or analytes to be used in a an ex vivo or in vitro assays. Such tissues include but are not limited to blood, saliva, sputum, lymph, cellular mass, and tissue collected from a biopsy.
Kinase Inhibitor Resistant Panels
In one aspect, disclosed herein are kinase inhibitor resistance panels such as, for example, an ALK kinase inhibitor panel. Kinase inhibitors are known in the art and have found use in the treatment of, amongst other things, the treatment of cancer. For example, cancers involving the overexpression or fusion of Analplastic Lymphoma Kinase can be treated through the use of a kinase inhibitor. Kinase inhibitors are known in the art and include, but are not limited to crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib,
Sunitinib, Trastuzumab, and Vemurafenib. Thus, in one aspect, disclosed herein are kinase inhibitor resistance panels for detecting susceptibility or resistance to treatment in a subject to a kinase inhibitor comprising crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, or Vemurafenib.
Unfortunately, mutations in the ALK sequence and other genes, such as, BRAF, KIT, KRAS, and EGFR can lead to kinase inhibitor resistance. These mutations can comprise any
of the mutations to ALK, KIT, BRAF, KRAS, or EGFR listed in Tables 2, 3, 4, 5, or 6.
Accordingly, in a further aspect, disclosed herein are kinase inhibitor panels comprising one or more primer sets that selectively hybridize and can be used to amplify one of the genes selected from group of genes comprising KRAS(SEQ ID NO: 7718), BRAF(SEQ ID NO: 7717), EGFR (SEQ ID NO: 7716), ALK (SEQ ID NO: 7714 and SEQ ID NO: 7717
(cDNA)), and KIT. In one aspect, the kinase inhibitor resistance panel disclosed herein can comprise one or more primer set(s) that hybridizes and amplifies nucleic acid from exon 1 (SEQ ID NOs: 4601-4880 and 7181-7230) exon 2 (SEQ ID NOs: 4881-5200 and 7231- 7326) or both exons 1 and 2 (SEQ ID NOs: 7327-7610) ofKRAS; exon 18 (SEQ ID NOs: 1641 - 1760 and 5819-5934), exon 19 (SEQ ID NOs : 1761 - 1880), exon 20 (SEQ ID NOs : 1881-2000 and 5934-6042), exon 21 (SEQ ID NOs: 2001-2120 and 6043-6150), exon 22 (SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440), exons 18 and 19 (SEQ ID NOs: 2241-2280), exons 18, 19, and 20 (SEQ ID NOs: 6151-6274), exons 20 and 21 (SEQ ID NOs: 2281-2320 and 6275-6388), or exons 18, 19, 20, and 21 (SEQ ID NOs: 2361-2400 and 6389-6524) oiEGFR; exon 8 (SEQ ID NOs: 2441-2800), exon 9 (SEQ ID NOs: 2841- 3120), exon 10 (SEQ ID NOs: 3201-3360), exon 11 (SEQ ID NOs: 3361-3480), exon 12 (SEQ ID NOs: 3481-3640), exon 13 (SEQ ID NOs: 3641-3800), exon 17 (SEQ ID NOs: 4241-4600), exon 8 and 9 (SEQ ID NOs: 2801-2840), exons 9 and 10 (SEQ ID NOs: 3121- 3160), exons 9, 10, and 11 (SEQ ID NOs: 3161-3200); exons 10 and 11 (SEQ ID NOs: 3801-3960), exons 12 and 13 (SEQ ID NOs: 3961-4120), or exons 10, 11, 12, and 13 (SEQ ID NOs: 4121-4240) of KIT; exons 10 and 11 (SEQ ID NOs: 6525-6832) or exons 13, 14, or 15 (SEQ ID NOs: 66833-7180) oiBRAF, and/or exon 21 (SEQ ID NOs: 1-160), exon 22 (SEQ ID NOs: 401-560), exon 23 (SEQ ID NOs: 561-840 and 5311-5446), exon 24 (SEQ ID NOs: 921-1240), exon 25 (SEQ ID NOs: 1241-1600), exons 21 and 22 (SEQ ID NOs: 161-400 and 5201-5310), exons 21, 22, and 23 (SEQ ID NOs: 841-920), exons 24 and 25 (SEQ ID NOs: 1601-1640 and 5447-5576), or exons 21, 22, 23, 24, and 25 (SEQ ID NOs: 5577-5818) of ALK As disclosed herein "primer set" refers to a forward and reverse primer pair (i.e., a left and right primer pair) that can be used together to amplify a given region of
a nucleic acid (e.g., DNA, RNA, or cDNA) of interest. Thus, panels with multiple primer sets include multiple primer pairs. It is understood and herein contemplated that some primer sets may have a common forward or reverse primer and thus have an odd number of primers.
It is further understood and herein contemplated that the disclosed kinase inhibitor resistant panels can comprise a single primer sets that hybridizes to a single gene, region, or exon of a gene selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i. Q, a single primer sets for KRAS, BRAF, EGFR, ALK, or KIT); multiple primer sets that hybridize to a single gene, region, or exon of a gene selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, one or more primer sets for KRAS, BRAF, EGFR, ALK, or KIT); multiple primer sets comprising a single primer set that specifically hybridize to a single gene, region, or exon for each of the genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, a single primer set for each oiKRAS, BRAF, EGFR, ALK, and/or KIT); or multiple primer sets comprising where in there is more than one primer set for each gene, region or exon for each of the genes selected from the group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT (i.e, one or more primer sets for each oiKRAS, BRAF, EGFR, ALK, and/or KIT). Thus, it is contemplated herein that the kinase inhibitor panel can comprise primer sets that recognize and specifically hybridize to a gene, region, or exon, of one or combination of the gene selected from the group consisting oiKRAS, BRAF, EGFR, ALK, and KIT. For example, the panel can comprise primer sets that hybridize to a gene, region, or exon oiKRAS, BRAF, EGFR, ALK, or KIT; KRAS and BRAF; KRAS and EGFR; KRAS and ALK; KRAS and KIT; BRAF and EGFR; BRAF and KIT; BRAF and ALK; EGFR and ALK; EGFR and KIT; ALK and KIT; KRAS, BRAF, and EGFR; KRAS, BRAF, and ALK; KRAS, BRAF, and KIT; KRAS, EGFR, and ALK; KRAS, EGFR, and KIT; KRAS, ALK, and KIT; BRAF, EGFR, and ALK, BRAF,
EGFR, and KIT; BRAF, ALK, and KIT; EGFR, ALK, and KIT; KRAS, BRAF, EGFR, and ALK; KRAS, BRAF, EGFR, and KIT, BRAF, EGFR, ALK, and KIT; and KRAS, BRAF, EGFR, ALK, and KIT.
For example, the primer or primer sets in the kinase inhibitor resistance panel can detect any of the mutations in Tables 2-6. In another aspect, the primers or primer sets used in the inhibitor resistance panel can comprise one or more of the primers or primer sets listed in Tables 7-14 as disclosed herein and/or probes listed in Table 15 (i.e., SEQ ID NOs: 7611-7613).
Methods of detecting the presence of a kinase inhibitor resistant cancer
The disclosed kinase inhibitor resistant panels, in one aspect, contain primers or primer sets for the detection of mutations that confer kinase inhibitor resistance. Thus, in another aspect disclosed herein are methods and assays for the detection of kinase inhibitor resistant forms of an ALK-rslatsd cancer. For example, disclosed herein are methods and assays for the detection of kinase inhibitor resistance, such as, for example ALK kinase inhibitor resistance, comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor. In one aspect, the mutation can be a nucleic acid mutation in ALK, EGFR, KRAS, BRAF, or KIT. For example, the mutation can be any mutation listed in Tables 2-6. In a further aspect, the disclosed methods and assays for detection of kinase inhibitor resistance can comprise performing next generation sequencing using a kinase inhibitor resistant panel as disclosed herein which comprises a primer or primer set that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 οΐΚΙΤ; exon 10, 11, 13, 14, or 15 oiBRAF, and/or exon 21 , 22, 23, 24, or 25 oiALK. For example, the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14. Thus, disclosed herein are methods wherein the one or more primer set(s) that hybridizes and amplifies nucleic acid from exon 1 (SEQ ID NOs: 4601-4880 and 7181-7230) exon 2 (SEQ ID NOs: 4881-5200 and 7231-
7326) or both exons 1 and 2 (SEQ ID NOs: 7327-7610) oiKRAS; exon 18 (SEQ ID NOs: 1641 - 1760 and 5819-5934), exon 19 (SEQ ID NOs : 1761 - 1880), exon 20 (SEQ ID NOs : 1881-2000 and 5934-6042), exon 21 (SEQ ID NOs: 2001-2120 and 6043-6150), exon 22 (SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440), exons 18 and 19 (SEQ ID NOs: 2241-2280), exons 18, 19, and 20 (SEQ ID NOs: 6151-6274), exons 20 and 21 (SEQ ID NOs: 2281-2320 and 6275-6388), or exons 18, 19, 20, and 21 (SEQ ID NOs: 2361-2400 and 6389-6524) oiEGFR; exon 8 (SEQ ID NOs: 2441-2800), exon 9 (SEQ ID NOs: 2841- 3120), exon 10 (SEQ ID NOs: 3201-3360), exon 11 (SEQ ID NOs: 3361-3480), exon 12 (SEQ ID NOs: 3481-3640), exon 13 (SEQ ID NOs: 3641-3800), exon 17 (SEQ ID NOs: 4241-4600), exon 8 and 9 (SEQ ID NOs: 2801-2840), exons 9 and 10 (SEQ ID NOs: 3121- 3160), exons 9, 10, and 11 (SEQ ID NOs: 3161-3200); exons 10 and 11 (SEQ ID NOs: 3801-3960), exons 12 and 13 (SEQ ID NOs: 3961-4120), or exons 10, 11, 12, and 13 (SEQ ID NOs: 4121-4240) οΐΚΙΤ; exons 10 and 11 (SEQ ID NOs: 6525-6832) or exons 13, 14, or 15 (SEQ ID NOs: 66833-7180) oiBRAF, and/or exon 21 (SEQ ID NOs: 1-160), exon 22 (SEQ ID NOs: 401-560), exon 23 (SEQ ID NOs: 561-840 and 5311-5446), exon 24 (SEQ ID NOs: 921-1240), exon 25 (SEQ ID NOs: 1241-1600), exons 21 and 22 (SEQ ID NOs: 161-400 and 5201-5310), exons 21, 22, and 23 (SEQ ID NOs: 841-920), exons 24 and 25 (SEQ ID NOs: 1601-1640 and 5447-5576), or exons 21, 22, 23, 24, and 25 (SEQ ID NOs: 5577-5818) oiALK.
It is understood that the disclosed methods can further comprise synthesizing cDNA from the nucleic acid extracted from a tissue sample before detection of a mutation in ALK, EGFR, KRAS, BRAF, or KIT. Thus, in one aspect, disclosed herein are methods for detecting kinase inhibitor resistance in a cancer in a subject, for example ALK kinase inhibitor resistance, comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-rolatsd cancers); synthesixing cDNA from the tissue sample, and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid
sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
It is further understood and herein contemplated that the subject of the disclosed methods can be a subject that has been previously diagnosed with a cancer including but not limited to inflammatory breast cancer, non-small cell lung carcinoma, esophageal squamous cell carcinoma, colorectal carcinoma, Inflammatory myofibroblastic tumor, familial and sporadic neuroblastoma. In yet another aspect, the subject has been previously diagnosed with a cancer that results from ALK, ROS1, RET, DEPDC1 overexpression, dysregulation, or fusion. Examples of such fusions include but are not limited to nucleophosmin-^Z T (NPM-ALK), 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase (ATIC-ALK), clathrin heavy chain-ALK (CLTC-ALK), kinesin-1 heavy chain gene-ALK (KIF5B-ALK); Ran-binding protein 2-ALK (RANBP2- ALK), SEC31L1- ALK, tropomyosin^-.^ (ΤΡΜ3-.4Ζ 0, tropomyos -4-ALK (TFM4-ALK), TRK-fused gene(Large) -ALK (TFGL-ALK), TRK-fused gene(Small) -ALK (TFGs-ALK), CARS-ALK, EML4-^ ^, 5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase-ALK (ATIC-ALK), AL017 -ALK, moQsin- ALK (MSN -ALK), non-muscle myosin heavy chain gsns-ALK (MYH9-ALK), and TRK-fused gene(Extra Large) -ALK (TFGXL-ALK). In a further aspect, the present methods could not only be used to diagnose a kinase inhibitor resistant cancer , but diagnose the cancer itself as the subject with a kinase inhibitor resistant cancer would necessarily not only have a cancer, but have a kinase related cancer such as those disclosed herein .
Therefore, in one aspect, disclosed herein are methods for the detection of kinase inhibitor resistance comprising obtaining a tissue sample from a subject with a cancer and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample using one or more primer sets or primer panels with primer sets that specifically hybridizes to one or more of the genes selected from the group consisting of ALK, KRAS, EGFR, KIT, and BRAF, wherein the presence of a mutation in the nucleic acid
sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
Also disclosed are methods, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 18, 19, 20, 21 or 22 oiEGFR, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 21, 22, 23, 24, or 25 oiALK, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 8, 9, 10, 11, 12, 13, or 17 οΐΚΙΤ, and/or wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 10, 11, 13, 14, or 15 oiBRAF.
In one aspect, disclosed are methods, wherein one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of Tables 10 and/or 14 (SEQ ID NOs: 4601-5200 and 7181-7610); wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of Tables 8 and/or 12 (1641-2440 and 5819-6524); wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of Tables 7 and/or 1 1 (SEQ ID NOs: 1-1640 and 5201-5818); wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of Table 9 ( SEQ ID NOs: 2441-4600); and/or wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of Table 13 (SEQ ID NOs: 6525-7180).
In one aspect are methods comprising the use of a kinase inhibitor resistance panel, wherein the panel comprises 2, 3, 4, 5, 6, 7, 8, 9, 10, or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
In another aspect, disclosed are methods wherein the panel comprises one or more primer sets for 2, 3, 4, of all 5 of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
Also disclosed are methods, wherein the kinase inhibitor is selected from the group consisting of crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib,
Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, and Vemurafenib.
Methods, assays, and primer panels for assessing the suitability of ALK directed treatments
Though not wishing to be bound by current theories, it is believed that inhibition of these over-expression or aberrant expressions of ALK it small-molecule drug candidates abrogates related abnormal cell proliferation and promotes apoptosis in ALK-rslatsd tumor cell lines. Furthermore, both preclinical animal models and the early clinical experience with these inhibitors indicate that ALK small-molecule inhibitors not only possess marked antitumor activity against ^Z T-related cancers but are also very well tolerated with no limiting target-associated toxicities. Therefore, such small molecules can be used to treat ALK-AnvQn cancers.
However, the presence of a mutation in one of the genes associated with an ALK- related cancer can confer resistance to treatment with a kinase inhibitor, such as an ALK kinase inhibitor. Nevertheless, knowledge of the presence of said mutation can still be useful to the practicing physician in assessing the suitability of a treatment or prescribing a particular treatment regimen. For example, the presence of a mutation in a gene which confers kinase inhibitor resistance, such as, for example, ALK kinase inhibitor resistance, can inform the skilled artisan to choose a particular kinase inhibitor over another due to the presence of a mutation affecting one kinase inhibitor and not the other. Alternatively, the presence of a mutation can inform the physician to discontinue the course of treatment with one kinase inhibitor due to detection of kinase inhibitor resistance and select a different kinase inhibitor to which the patient is not yet resistant. Accordingly, disclosed herein are methods and assays for assessing the suitability of an ALK inhibitor treatment for a cancer, for example, NSCLC, in a subject comprising performing high throughput sequencing on nucleic acid from a tissue sample from the subject; wherein the presence of a mutation in ALK, EGFR, BRAF, KRAS, or KIT indicates a cancer that comprises resistance to an ALK
kinase inhibitor. In one aspect, disclosed herein are methods and assays for assessing a subject's suitability for treatment with a kinase inhibitor comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-rslatsd cancers); detecting the presence of a mutation through sequencing or other nucleic acid detection technique for the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor and therefore continued use of an inhibitor to which the cancer has become resistant or to which the cancer is already resistant should be discontinued in favor of a cancer to which resistance has not developed.
It is understood and herein contemplated that any of the disclosed nucleic acid sequencing techniques disclosed herein can be used in these methods. Thus, disclosed herein are methods and assays assessing the suitability of an ALK kinase inhibitor treatment for an ALK related cancer in a subject comprising conducting high throughput sequencing (also known as next generation sequencing) on nucleic acid such as mRNA or DNA from a tissue sample from the subject; wherein the sequencing reaction reveals the nucleic acid sequence for one or more exons οΐΚΙΤ, BRAF, KRAS, EGFR, and ALK; and wherein the presence of one or more mutations in KIT, BRAF, KRAS, EGFR, and/or ALK indicates the presence of kinase inhibitor resistance. The mutations can occur in any exon οΐΚΙΤ, BRAF, KRAS, EGFR, and ALK. Thus, for example, the mutations can occur in and therefore the primers or primer sets can hybridize to exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 r 22 of EGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 οΐΚΙΤ; exon 10, 11, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK. In one aspect, the mutation can comprise any one or more of the mutations listed in Tables 2-6. It is further understood that the disclosed methods and assays can further comprise any of the primers disclosed herein in Tables 7-14 or probes listed in Table 15 and utilize the multiplexing PCR techniques disclosed.
In another aspect, two or more of the disclosed primers and primer sets can comprise a primer panel can be used in methods and assays for the assessment of the suitability of a kinase inhibitor for the treatment of a subjects' cancer. In one aspect, the primer panel
comprises one or more primers that can detect a nucleic acid mutation in ALK, BRAF, EGFR, KRAS, or KIT. In a further aspect, the primers or primer sets that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 οΐΚΙΤ; exon 10, 1 1, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK. In another aspect, the disclosed primer panel can comprise any primer or primer set which detects one or more of the mutations found in Tables 2-6. For example, the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14.
In another aspect, knowledge of kinase inhibitor resistant cancer can be used to screen for a drug that is not a kinase inhibitor. Thus, in one aspect, disclosed herein are methods of screening for a drug to treat a subject with a cancer comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK- related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor, and contacting a tissue sample from subject with a cancer with an agent; wherein an agent that inhibits or reduces the growth or development of a kinase inhibitor resistant cancer is not a kinase inhibitor. The disclosed methods can further comprise the sue of the kinase inhibitor resistant panels disclosed herein or any of the primers, primer sets or probes disclosed herein. The methods can also further comprise the treatment of a subject with a kinase inhibitor resistant cancer with an agent that is identified in the method as not being a kinase inhibitor or discontinuing treatment in a subject with kinase inhibitor resistant cancer with an agent that has been found to be a kinase inhibitor.
Methods of identifying subjects for participation in clinical trials to screen for new cancer treatments.
In one aspect, it is contemplated herein that the identification of individuals with a kinase inhibitor resistant cancer can be useful for establishing clinical trials to screen for drugs that can be used to treat individuals with kinase inhibitor resistant cancers. Thus, in one aspect, disclosed herein are methods for identifying a subject for screening for a drug that can treat a cancer in a subject with a kinase inhibitor resistant cancer, for example ALK kinase inhibitor resistance, comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-related cancers); and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor and the subject can be used in trials to screen for a drug to which a kinase inhibitor resistant subject will respond. In one aspect, the mutation can be a nucleic acid mutation in ALK, EGFR, KRAS, BRAF, or KIT. For example, the mutation can be any mutation listed in Tables 2-6. In one aspect, said methods can further comprise synthesizing cDNA from the tissue sample of the subject.
It is understood and herein contemplated that the disclosed methods can be used in conjunction with any of the kinase inhibitor resistant panels, primer sets, or probes disclosed herein. For example, the disclosed methods can be performed using a primer or primer set that hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS; exon 18, 19, 20, 21 or 22 oiEGFR; exon 8, 9, 10, 1 1, 12, 13, or 17 οΐΚΙΤ; exon 10, 1 1, 13, 14, or 15 oiBRAF, and/or exon 21, 22, 23, 24, or 25 oiALK. For example, the primer or primer set can comprise any of the primers or primer sets disclosed in Tables 7-14. Thus, disclosed herein are methods wherein the one or more primer set(s) that hybridizes and amplifies nucleic acid from exon 1 (SEQ ID NOs: 4601-4880 and 7181-7230) exon 2 (SEQ ID NOs: 4881- 5200 and 7231-7326) or both exons 1 and 2 (SEQ ID NOs: 7327-7610) ofKRAS; exon 18 (SEQ ID NOs: 1641-1760 and 5819-5934), exon 19 (SEQ ID NOs: 1761-1880), exon 20 (SEQ ID NOs: 1881-2000 and 5934-6042), exon 21 (SEQ ID NOs: 2001-2120 and 6043- 6150), exon 22 (SEQ ID NOs: 2121-2240, 2321-2360, and 2401-2440), exons 18 and 19
(SEQ ID NOs: 2241-2280), exons 18, 19, and 20 (SEQ ID NOs: 6151-6274), exons 20 and
21 (SEQ ID NOs: 2281-2320 and 6275-6388), or exons 18, 19, 20, and 21 (SEQ ID NOs: 2361-2400 and 6389-6524) oiEGFR; exon 8 (SEQ ID NOs: 2441-2800), exon 9 (SEQ ID NOs: 2841-3120), exon 10 (SEQ ID NOs: 3201-3360), exon 1 1 (SEQ ID NOs: 3361-3480), exon 12 (SEQ ID NOs: 3481-3640), exon 13 (SEQ ID NOs: 3641-3800), exon 17 (SEQ ID NOs: 4241-4600), exon 8 and 9 (SEQ ID NOs: 2801-2840), exons 9 and 10 (SEQ ID NOs: 3121-3160), exons 9, 10, and 1 1 (SEQ ID NOs: 3161-3200); exons 10 and 11 (SEQ ID NOs: 3801-3960), exons 12 and 13 (SEQ ID NOs: 3961-4120), or exons 10, 1 1, 12, and 13 (SEQ ID NOs: 4121-4240) of ATT; exons 10 and 1 1 (SEQ ID NOs: 6525-6832) or exons 13, 14, or 15 (SEQ ID NOs: 66833-7180) oiBRAF, and/or exon 21 (SEQ ID NOs: 1-160), exon
22 (SEQ ID NOs: 401-560), exon 23 (SEQ ID NOs: 561-840 and 5311-5446), exon 24 (SEQ ID NOs: 921-1240), exon 25 (SEQ ID NOs: 1241-1600), exons 21 and 22 (SEQ ID NOs: 161-400 and 5201-5310), exons 21, 22, and 23 (SEQ ID NOs: 841-920), exons 24 and 25 (SEQ ID NOs: 1601-1640 and 5447-5576), or exons 21, 22, 23, 24, and 25 (SEQ ID NOs: 5577-5818) οΐΑΣΚ.
Methods of detecting a kinase inhibitor resistance in an ^4ZJ£-related cancer
In another aspect, the disclosed methods and assays relate to the detection or diagnosis of the presence of a kinase inhibitor resistance, such as, for example, ALK kinase inhibitor resistance, in a disease or condition such as a cancer and methods and assays for the determination of susceptibility or resistance to therapeutic treatment for a disease or condition such as a cancer in a subject comprising detecting the presence or measuring the expression level of nucleic acid (for example, DNA, mRNA, cDNA, RNA, etc) through the use of next generation sequencing (NGS) from a tissue sample from the subject; wherein the presence of a mutations in the nucleic acid code of the KIT, BRAF, KRAS, EGFR, or ALK gene or the ALK gene portion of an ALK fusion construct indicates the presence of a cancer that is resistant to a kinase inhibitor. In one aspect, the cancer is associated with
amplification, overexpression, nucleic acid variation, truncation, or gene fusion oiALK. It is
understood, that the kinase inhibitor resistance panels disclosed herein can be used to perform said methods and the detection of one or more of the mutations in Tables 2-6 indicates the presence of kinase inhibitor resistance. In one aspect, the disclosed methods can further comprise discontinuing use of a kinase inhibitor to treat a cancer in a subject that has been identified with a kinase inhibitor resistant cancer. In another embodiment, the disclosed methods can further comprise treating a subject with a kinase inhibitor resistant cancer with a chemotherapeutic that is not a kinase inhibitor. Thus, in one aspect, disclosed herein are methods of treating a subject with a kinase inhibitor resistant cancer (such as, for example, an ALK kinase inhibitor resistant cancer) comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-rslatsd cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the presence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject has a cancer is resistant or will become resistant to a kinase inhibitor; and treating the subject with a chemotherapeutic that is not a kinase inhibitor. Also disclosed are methods of treating a subject without a kinase inhibitor resistant cancer comprising obtaining a tissue sample from a subject with a cancer, such as a kinase related cancer (e.g., ALK-related cancers); conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample, wherein the absence of a mutation in the nucleic acid sequence of a gene, region, or exon associated with kinase inhibitor resistance indicates that that the subject does not have a cancer is resistant nor will become resistant to a kinase inhibitor; and treating the subject with a kinase inhibitor.
Anaplastic Lymphoma Kinase (ALK)
ALK (SEQ ID NO: 7714 (Genbank Accession No. U62540 (human coding sequence)) is a receptor tyrosine kinase (RTK) of the insulin receptor superfamily encoded by the ALK gene and is normally expressed primarily in the central and peripheral nervous systems. The I620aa ALK polypeptide comprises a 1030aa extracellular domain which
includes a 26aa amino-terminal signal peptide sequence, and binding sites located between residues 391 and 401 for the ALK ligands pleiotrophin (PTN) and midkine (MK).
Additionally, the ALK polypeptide comprises a kinase domain (residues 1 1 16-1383) which includes three tyrosines responsible for autophosphorylation within the activation loop at residues 1278, 1282, and 1283. ALK amplification, overexpression, and mutations have been shown to constitutively activate the kinase catalytic function of the ALK protein, with the deregulated mutant ALK in turn activating downstream cellular signaling proteins in pathways that promote aberrant cell proliferation. In fact, the mutations that result in dysregulated ALK kinase activity are associated with several types of cancers.
ALK fusions represent the most common mutation of this tyrosine kinase. Such fusions include but are not limited to nucleophosmin-^Z T (NPM-ALK), 5-aminoimidazole- 4-carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase (ATIC-ALK), clathrin heavy chain-ALK (CLTC-ALK), kinesin-1 heavy chain gsm-ALK (KIF 5B-ALK); Ran- binding protein 2-ALK (RANBP2-ALK), SEC3 I l-ALK, tropomyosin-3- ΖΑ" (TPM3- ALK), tropomyosin^^ (TFM4-ALK), TRK-fused gene(Large) -ALK (TFGL-ALK),
TRK-fused gene(Small) -ALK (TFGS-ALK), CARS-ALK, LML4-ALK, 5-aminoimidazole-4- carboxamide ribonucleotide formyltransferase/IMP cyclohydrolase-ALK (ATIC-ALK), ALO 17 -ALK, moesin-^Z T (MSN-ALK), non-muscle myosin heavy chain gsns-ALK (MYH9-ALK), and TRK-fused gene(Extra Large) -ALK (TFGXL-ALK). Six ALK fusions, CARS-ALK. CLTC-ALK, RA BP2-^ ^, SEC3 -ALK, TFM3-ALK, and TFM4-ALK have been identified in IMTs. TPMS-ALK, TPM4-ALK and CLTC-ALK fusions have been detected in both classical T- or null-cell lymphomas and IMT sarcomas, whereas CARS- ALK, RA BP2-^ ^, and SEC3 ILI-ALK occur in IMT. CLTC-ALK and NFM-ALK also occur in B-cell plasmablastic/immunoblastic lymphomas. The TPM4-ALK fusion occurs in esophageal squamous cell carcinomas, and the ALK fusion LML4-ALK , TFG-ALK and
Y T5B-ALK are found in non-small cell lung cancers. EML4-ALK has also recently been identified in both colorectal and breast carcinomas as well.
ALK fusions are associated with several known cancer types. It is understood that one or more ALK fusions can be associated with a particular cancer. It is further understood that there are several types of cancer associated with ALK fusions including but not limited to anaplastic large-cell lymphoma (ALCL), neuroblastoma, breast cancer, ovarian cancer, colorectal carcinoma, non-small cell lung carcinoma, diffuse large B-cell lymphoma, esophageal squamous cell carcinoma, anaplastic large-cell lymphoma, neuroblastoma, inflammatory myofibroblastic tumors, malignant histiocytosis, and glioblastomas.
ALCL. anaplastic large-cell lymphomas comprise -2.5% of all NHL; within the pediatric age group specifically, -13% of all NHL (30 - 40% of all childhood large-cell lymphomas) are of this type. Studies of ALCL patients now divide this NHL into ALK- positive and ALK-negative subsets; -60% of all ALCLs are caused by ALK fusions. For unclear reasons, ALK-positive ALCL patients fare significantly better following CHOP based multi-agent conventional chemotherapy than those with ALK-negative disease (with overall 5-year survivals of -75% vs. -35%, respectively). However, more than a third of patients suffer multiple relapses following chemotherapy, thus the 5-year disease-free survival of ALK-positive ALCL is only -40%.
ALK+ Diffuse large B-cell lymphoma. In 2003, ALK fusions were shown to occur in a non-ALCL form of NHL with the description of CLTC-ALK or NPM-ALK in diffuse large B-cell lymphomas (ALK+ DLBCLs). Consistent with their B-lineage, these NHLs express cytoplasmic IgA and plasma cell markers, and possess an immunoblastic morphology. Translational research studies revealed the t(2; 17) and CLTC-ALK mRN A in the majority of these lymphomas, while immunolabeling confirmed granular ALK staining identical to that observed in CLTC-ALK-positive ALCL. As for all other ALK fusion partner proteins, a self-association motif in the CLTC portion of CLTC-ALK mediates constitutive self-association and activation of the fusion kinase to drive lymphomagenesis. ALK+ DLBCLs occur predominately in adults; however, the t(2;5) and NPM-ALK mRNA in pediatric lymphomas are phenotypically identical to CLTC-ALK- positive adult B-NHLs.
Approximately 0.5-1% of all DLBCL is thought to be ALK-positive. The identification of DLBCLs caused by mutant ALK is important because patients with these lymphomas have outcomes that are much inferior to ALK-negative DLBCL patients following CHOP-based treatments; thus, ALK+ DLBCL patients should strongly be considered as candidates for ALK-targeted kinase inhibitor therapy.
ALK+ systemic histiocytosis. ALK fusions were described in 2008 in another hematopoietic neoplasm, systemic histiocytosis. Three cases of this previously
uncharacterized form of histiocytosis, which presents in early infancy, exhibited ALK immunoreactivity and the one case analyzed molecularly expressed TPM3-ALK.
In addition to the aforementioned hematological malignancies in which
constitutively activated ALK fusions have been shown to be a causative mechanism in many cases, the genesis of subsets of various solid tumors in some instances, very common human tumors such as non-small cell lung cancer, colorectal and breast cancers has recently been demonstrated to be due to aberrantly activated ALK.
Inflammatory myofibroblasts tumor. The first non-hematopoietic tumor discovered to express ALK fusions was the sarcoma known as inflammatory myofibroblastic tumor (IMT), a spindle cell proliferation in the soft tissue and viscera of children and young adults (mean age at diagnosis ~10 years). Many IMTs are indolent and can be cured by resection. However, locally recurrent, invasive, and metastatic IMTs are not uncommon and current chemo- and radio-therapies are completely ineffective. Disclosed herein is the involvement of chromosome 2p23 (the location of the ALK gene) in IMTs, as well as ALK gene rearrangement. ALK immunoreactivity in 7 of 11 IMTs has been shown and TPM3-ALK and TPM4-ALK were identified in several cases. Additionally, two additional ALK fusions in IMT, CLTC- and RanBP2-ALK were identified. ALK fusions have also been examined by immunostaining in 73 IMTs, finding 60% (44 of the 73 cases) to be ALK-positive. Thus, ALK deregulation is of pathogenic importance in a majority of IMTs.
Non-small cell lung carcinoma. The role of ALK fusions in cancer expanded further with the description of the novel EML4-ALK chimeric protein in 5 of 75 (6.7%) Japanese
non-small cell lung carcinoma patients. Shortly thereafter, the existence of ALK fusions in lung cancer was corroborated by a different group who found 6 of 137 (4.4%) Chinese lung cancer patients to express ALK fusions (EML4-ALK, 3 pts; TFG-ALK, 1 pt; X-ALK. Two common themes have emerged - 1) ALK fusions occur predominately in patients with adenocarcinoma (although occasional ALK-positive NSCLCs of squamous or mixed histologies are observed), mostly in individuals with minimal/no smoking history, and 2) ALK abnormalities usually occur exclusive of other common genetic abnormalities (e.g., EGFR and KRAS mutations). The exact percentage of NSCLCs caused by ALK fusions is not yet clear but estimates based on reports in the biomedical literature suggest a range of -5-10%.
Esophageal squamous cell carcinoma. In 45 Iranian patients, a proteomics approach identified proteins under or over-represented in esophageal squamous cell carcinomas (ESCCs); TPM4-ALK was among those proteins over-represented. A second proteomics- based ESCC study - in this case, in Chinese patients - identified TPM4-ALK in these tumors as well.
Colorectal carcinoma, breast cancer. Three human tumor types - colorectal, breast, and non-small cell lung cancers were surveyed for the presence of the EML4-ALK fusion (other ALK mutations were not assessed in this study). In addition to confirming the expression of EML4-ALK in NSCLC (in 12 of 106 specimens studied, 1 1.3%), a subsets of breast (5 of 209 cases, 2.4%) and colorectal (2 of 83 cases, 2.4%) carcinomas were EML4- ALK-positive. In addition to known EML4-ALK variants 1 (E13; A20) and 2 (E20; A20), a novel variant (E21 ; A20) was found in colorectal carcinoma.
ALK in familial and sporadic neuroblastoma. Neuroblastoma is the most common extracranial solid tumor of childhood, and is derived from the developing neural crest. A small subset (-1-2%) of neuroblastomas exhibit a familial predisposition with an autosomal dominant inheritance. Most neuroblastoma patients have aggressive disease associated with survival probabilities <40% despite intensive chemo- and radio-therapy, and the disease accounts for -15% of all childhood cancer mortality. ALK had previously been found to be
constitutively activated also due to high-level over-expression as a result of gene amplification in a small number of neuroblastoma cell lines, in fact, ALK amplification occurs in -15% of neuroblastomas in addition to activating point mutations. These missense mutations in ALK have been confirmed as activating mutations that drive neuroblastoma growth; furthermore, incubation of neuroblastoma cell lines with ALK small-molecule inhibitors reveal those cells with ALK activation (but not cell lines with normal levels of expression of wild-type ALK) to exhibit robust cytotoxic responses.
The sensitive detection of a mutation at a known site in DNA is readily done with existing technologies. Allele specific primers can be designed to target a mutation at a known location such that its signal can be preferentially amplified over wild-type DNA.
Next Generation Sequencing for Genetic Testing
From a technical perspective High-throughput or Next Generation Sequencing (NGS) represents an attractive option for detecting the somatic mutations within a gene. Unlike PCR, microarrays, high-resolution melting and mass spectrometry, which all indirectly infer sequence content, NGS directly ascertains the identity of each base and the order in which they fall within a gene. The newest platforms on the market have the capacity to cover an exonic region 10,000 times over, meaning the content of each base position in the sequence is measured thousands of different times. This high level of coverage ensures that the consensus sequence is extremely accurate and enables the detection of rare variants within a heterogeneous sample. For example, in a sample extracted from FFPE tissue, relevant mutations are only present at a frequency of 1% with the wild-type allele comprising the remainder. When this sample is sequenced at 10,000X coverage, then even the rare allele, comprising only 1% of the sample, is uniquely measured 100 times over. Thus, NGS can provide reliably accurate results with very high sensitivity, making it ideal for clinical diagnostic testing of FFPEs and other mixed samples.
In one aspect, disclosed herein are methods and assays for detecting kinase inhibitor resistance or determining the susceptibility to a particular kinase inhibitor treatment in an
ALK-related cancer comprising performing next generation sequencing on a tissue sample obtained from a subject with an ALK-related cancer, wherein the presence of a nucleic acid variation in the ALK, BRAF, EGFR, KIT, or KRAS sequence of the tissue sample at a nucleic acid residue indicates that presence of kinase inhibitor resistance. For example, the methods and assays for detecting kinase inhibitor resistance or determining the susceptibility or developing kinase inhibitor resistance in an ALK-related cancer or determining the suitability of a particular kinase inhibitor for use in treating an ALK-related cancer in a subject can comprise the detection of any of the mutations in Tables 2-6. It is understood that the methods and assays can further comprise comparing the sequence to known kinase inhibitor resistance mutations list and determining what if any kinase inhibitors are affected by the mutation and altering or maintaining treatment as appropriate to utilize kinase inhibitors that are unaffected by the mutation. As the disclosed methods and assays employ the use of primers or primer sets to detect mutations that confer kinase inhibitor resistance, also disclosed herein are primer panels for use in next generation sequencing for the determination of kinase inhibitor resistance comprising one or more primer sets from each οΐΚΙΤ, BRAF, KRAS, EGFR, and ALK, for example, the disclosed primer panels, methods, and assays can comprise one or more of the primers or primer sets listed in Tables 7-14.
Examples of Next Generation Sequencing techniques include, but are not limited to Massively Parallel Signature Sequencing (MPSS), Polony sequencing, pyrosequencing,
Reversible dye-terminator sequencing, SOLiD sequencing, Ion semiconductor sequencing, DNA nanoball sequencing, Helioscope single molecule sequencing, Single molecule real time (SMRT) sequencing, Single molecule real time (RNAP) sequencing, and Nanopore DNA sequencing.
MPSS was a bead-based method that used a complex approach of adapter ligation followed by adapter decoding, reading the sequence in increments of four nucleotides; this method made it susceptible to sequence-specific bias or loss of specific sequences.
Polony sequencing, combined an in vitro paired-tag library with emulsion PCR, an automated microscope, and ligation-based sequencing chemistry to sequence an E. coli genome at an accuracy of > 99.9999% and a cost approximately 1/10 that of Sanger sequencing.
A parallelized version of pyrosequencing, the method amplifies DNA inside water droplets in an oil solution (emulsion PCR), with each droplet containing a single DNA template attached to a single primer-coated bead that then forms a clonal colony. The sequencing machine contains many picolitre-volume wells each containing a single bead and sequencing enzymes. Pyrosequencing uses luciferase to generate light for detection of the individual nucleotides added to the nascent DNA, and the combined data are used to generate sequence read-outs. This technology provides intermediate read length and price per base compared to Sanger sequencing on one end and Solexa and SOLiD on the other.
A sequencing technology based on reversible dye-terminators. DNA molecules are first attached to primers on a slide and amplified so that local clonal colonies are formed. Four types of reversible terminator bases (RT-bases) are added, and non-incorporated nucleotides are washed away. Unlike pyrosequencing, the DNA can only be extended one nucleotide at a time. A camera takes images of the fluorescently labeled nucleotides, then the dye along with the terminal 3' blocker is chemically removed from the DNA, allowing the next cycle.
SOLiD technology employs sequencing by ligation. Here, a pool of all possible oligonucleotides of a fixed length are labeled according to the sequenced position.
Oligonucleotides are annealed and ligated; the preferential ligation by DNA ligase for matching sequences results in a signal informative of the nucleotide at that position. Before sequencing, the DNA is amplified by emulsion PCR. The resulting bead, each containing only copies of the same DNA molecule, are deposited on a glass slide. The result is sequences of quantities and lengths comparable to Illumina sequencing.
Ion semiconductor sequencing is based on using standard sequencing chemistry, but with a novel, semiconductor based detection system. This method of sequencing is based on
the detection of hydrogen ions that are released during the polymerization of DNA, as opposed to the optical methods used in other sequencing systems. A micro well containing a template DNA strand to be sequenced is flooded with a single type of nucleotide. If the introduced nucleotide is complementary to the leading template nucleotide it is incorporated into the growing complementary strand. This causes the release of a hydrogen ion that triggers a hypersensitive ion sensor, which indicates that a reaction has occurred. If homopolymer repeats are present in the template sequence multiple nucleotides will be incorporated in a single cycle. This leads to a corresponding number of released hydrogens and a proportionally higher electronic signal.
DNA nanoball sequencing is a type of high throughput sequencing technology used to determine the entire genomic sequence of an organism. The method uses rolling circle replication to amplify small fragments of genomic DNA into DNA nanoballs. Unchained sequencing by ligation is then used to determine the nucleotide sequence. This method of DNA sequencing allows large numbers of DNA nanoballs to be sequenced per run.
Helicos's single-molecule sequencing uses DNA fragments with added polyA tail adapters, which are attached to the flow cell surface. The next steps involve extension-based sequencing with cyclic washes of the flow cell with fluorescently labeled nucleotides (one nucleotide type at a time, as with the Sanger method). The reads are performed by the Helioscope sequencer.
SMRT sequencing is based on the sequencing by synthesis approach. The DNA is synthesized in zero-mode wave-guides (ZMWs) - small well-like containers with the capturing tools located at the bottom of the well. The sequencing is performed with use of unmodified polymerase (attached to the ZMW bottom) and fluorescently labeled nucleotides flowing freely in the solution. The wells are constructed in a way that only the fluorescence occurring by the bottom of the well is detected. The fluorescent label is detached from the nucleotide at its incorporation into the DNA strand, leaving an unmodified DNA strand.
Single molecule real time sequencing based on RNA polymerase (RNAP), which is attached to a polystyrene bead, with distal end of sequenced DNA is attached to another bead, with both beads being placed in optical traps. RNAP motion during transcription brings the beads in closer and their relative distance changes, which can then be recorded at a single nucleotide resolution. The sequence is deduced based on the four readouts with lowered concentrations of each of the four nucleotide types (similarly to Sangers method).
Nanopore sequencing is based on the readout of electrical signal occurring at nucleotides passing by alpha-hemolysin pores covalently bound with cyclodextrin. The DNA passing through the nanopore changes its ion current. This change is dependent on the shape, size and length of the DNA sequence. Each type of the nucleotide blocks the ion flow through the pore for a different period of time.
VisiGen Biotechnologies uses a specially engineered DNA polymerase. This polymerase acts as a sensor - having incorporated a donor fluorescent dye by its active centre. This donor dye acts by FRET (fluorescent resonant energy transfer), inducing fluorescence of differently labeled nucleotides. This approach allows reads performed at the speed at which polymerase incorporates nucleotides into the sequence (several hundred per second). The nucleotide fluorochrome is released after the incorporation into the DNA strand.
Sequencing by hybridization is a non-enzymatic method that uses a DNA microarray. A single pool of DNA whose sequence is to be determined is fluorescently labeled and hybridized to an array containing known sequences. Strong hybridization signals from a given spot on the array identify its sequence in the DNA being sequenced.
Mass spectrometry may be used to determine mass differences between DNA fragments produced in chain-termination reactions.
Another NGS approach is sequencing by synthesis (SBS) technology which is capable of overcoming the limitations of existing pyrosequencing based NGS platforms.
Such technologies rely on complex enzymatic cascades for read out, are unreliable for the accurate determination of the number of nucleotides in homopolymeric regions and require
excessive amounts of time to run individual nucleotides across growing DNA strands. The SBS NGS platform uses a direct sequencing approach to produce a sequencing strategy with very a high precision, rapid pace and low cost.
SBS sequencing is initialized by fragmenting of the template DNA into fragments, amplification, annealing of DNA sequencing primers, and finally affixing as a high-density array of spots onto a glass chip. The array of DNA fragments are sequenced by extending each fragment with modified nucleotides containing cleavable chemical moieties linked to fluorescent dyes capable of discriminating all four possible nucleotides. The array is scanned continuously by a high-resolution electronic camera (Measure) to determine the fluorescent intensity of each base (A, C, G or T) that was newly incorporated into the extended DNA fragment. After the incorporation of each modified base the array is exposed to cleavage chemistry to break off the fluorescent dye and end cap allowing additional bases to be added. The process is then repeated until the fragment is completely sequenced or maximal read length has been achieved.
mRNA detection and quantification
A number of widely used procedures exist for detecting and determining the abundance of a particular mRNA in a total or poly(A) RNA sample. For example, specific mRNAs can be detected using Northern blot analysis, nuclease protection assays (NPA), in situ hybridization (e.g., fluorescence in situ hybridization (FISH)), or reverse transcription- polymerase chain reaction (RT-PCR), and microarray.
In theory, each of these techniques can be used to detect specific RNAs and to precisely determine their expression level. In general, Northern analysis is the only method that provides information about transcript size, whereas NPAs are the easiest way to simultaneously examine multiple messages. In situ hybridization is used to localize expression of a particular gene within a tissue or cell type, and RT-PCR is the most sensitive method for detecting and quantitating gene expression.
RT-PCR allows for the detection of the RNA transcript of any gene, regardless of the scarcity of the starting material or relative abundance of the specific mRNA. In RT-
PCR, an RNA template is copied into a complementary DNA (cDNA) using a retroviral reverse transcriptase. The cDNA is then amplified exponentially by PCR using a DNA polymerase. The reverse transcription and PCR reactions can occur in the same or difference tubes. RT-PCR is somewhat tolerant of degraded RNA. As long as the RNA is intact within the region spanned by the primers, the target will be amplified.
Relative quantitative RT-PCR involves amplifying an internal control
simultaneously with the gene of interest. The internal control is used to normalize the samples. Once normalized, direct comparisons of relative abundance of a specific mRNA can be made across the samples. It is crucial to choose an internal control with a constant level of expression across all experimental samples (i.e., not affected by experimental treatment). Commonly used internal controls (e.g., GAPDH, β-actin, cyclophilin) often vary in expression and, therefore, may not be appropriate internal controls. Additionally, most common internal controls are expressed at much higher levels than the mRNA being studied. For relative RT-PCR results to be meaningful, all products of the PCR reaction must be analyzed in the linear range of amplification. This becomes difficult for transcripts of widely different levels of abundance.
Competitive RT-PCR is used for absolute quantitation. This technique involves designing, synthesizing, and accurately quantitating a competitor RNA that can be distinguished from the endogenous target by a small difference in size or sequence. Known amounts of the competitor RNA are added to experimental samples and RT-PCR is performed. Signals from the endogenous target are compared with signals from the competitor to determine the amount of target present in the sample.
Northern analysis is the easiest method for determining transcript size, and for identifying alternatively spliced transcripts and multigene family members. It can also be used to directly compare the relative abundance of a given message between all the samples on a blot. The Northern blotting procedure is straightforward and provides opportunities to evaluate progress at various points (e.g., intactness of the RNA sample and how efficiently it has transferred to the membrane). RNA samples are first separated by size via
electrophoresis in an agarose gel under denaturing conditions. The RNA is then transferred to a membrane, crosslinked and hybridized with a labeled probe. Nonisotopic or high specific activity radiolabeled probes can be used including random-primed, nick-translated, or PCR-generated DNA probes, in vitro transcribed RNA probes, and oligonucleotides. Additionally, sequences with only partial homology (e.g., cDNA from a different species or genomic DNA fragments that might contain an exon) may be used as probes.
The Nuclease Protection Assay (NPA) (including both ribonuclease protection assays and SI nuclease assays) is a sensitive method for the detection and quantitation of specific mRNAs. The basis of the NPA is solution hybridization of an antisense probe (radiolabeled or nonisotopic) to an RNA sample. After hybridization, single-stranded, unhybridized probe and RNA are degraded by nucleases. The remaining protected fragments are separated on an acrylamide gel. Solution hybridization is typically more efficient than membrane-based hybridization, and it can accommodate up to 100 μg of sample RNA, compared with the 20-30 μg maximum of blot hybridizations. NPAs are also less sensitive to RNA sample degradation than Northern analysis since cleavage is only detected in the region of overlap with the probe (probes are usually about 100-400 bases in length).
NPAs are the method of choice for the simultaneous detection of several RNA species. During solution hybridization and subsequent analysis, individual probe/target interactions are completely independent of one another. Thus, several RNA targets and appropriate controls can be assayed simultaneously (up to twelve have been used in the same reaction), provided that the individual probes are of different lengths. NPAs are also commonly used to precisely map mRNA termini and intron/exon junctions.
In situ hybridization (ISH) is a powerful and versatile tool for the localization of specific mRNAs in cells or tissues. Unlike Northern analysis and nuclease protection assays, ISH does not require the isolation or electrophoretic separation of RNA.
Hybridization of the probe takes place within the cell or tissue. Since cellular structure is
maintained throughout the procedure, ISH provides information about the location of mRNA within the tissue sample.
The procedure begins by fixing samples in neutral-buffered formalin, and embedding the tissue in paraffin. The samples are then sliced into thin sections and mounted onto microscope slides. (Alternatively, tissue can be sectioned frozen and post-fixed in paraformaldehyde.) After a series of washes to dewax and rehydrate the sections, a Proteinase K digestion is performed to increase probe accessibility, and a labeled probe is then hybridized to the sample sections. Radiolabeled probes are visualized with liquid film dried onto the slides, while non-isotopically labeled probes are conveniently detected with colorimetric or fluorescent reagents.
DNA detection and quantification
The methods, assays, and primer panels disclosed herein relate to the detection of nucleic acid variation that confer kinase inhibitor resistance in the form of, for example, point mutations and truncations of, KRAS, BRAF, KIT, EGFR, and/or ALK. Thus, in one aspect, disclosed herein are methods, assays, and use of the disclosed primer panels for diagnosing an anaplastic lymphoma kinase (ALK) related cancer in a subject is resistant to a kinase inhibitor comprise performing NGS which sequences DNA from a tissue sample from the subject. It is understood that high throughput sequencing methods (also known as next generation sequencing methods) can comprise any known amplification and detection method for DNA known in the art.
A number of widely used procedures exist for detecting and determining the abundance of a particular DNA in a sample. For example, the technology of PCR permits amplification and subsequent detection of minute quantities of a target nucleic acid. Details of PCR are well described in the art, including, for example, U.S. Pat. Nos. 4,683, 195 to Mullis et al, 4,683,202 to Mullis and 4,965, 188 to Mullis et al. Generally, oligonucleotide primers are annealed to the denatured strands of a target nucleic acid, and primer extension products are formed by the polymerization of deoxynucleoside triphosphates by a polymerase. A typical PCR method involves repetitive cycles of template nucleic acid
denaturation, primer annealing and extension of the annealed primers by the action of a thermostable polymerase. The process results in exponential amplification of the target nucleic acid, and thus allows the detection of targets existing in very low concentrations in a sample. It is understood and herein contemplated that there are variant PCR methods known in the art that may also be utilized in the disclosed methods, for example,
Quantitative PCR (QPCR); microarrays, real-time PCR; hot start PCR; nested PCR; allele- specific PCR; and Touchdown PCR.
Microarrays
An array is an orderly arrangement of samples, providing a medium for matching known and unknown DNA samples based on base-pairing rules and automating the process of identifying the unknowns. An array experiment can make use of common assay systems such as microplates or standard blotting membranes, and can be created by hand or make use of robotics to deposit the sample. In general, arrays are described as macroarrays or microarrays, the difference being the size of the sample spots. Macroarrays contain sample spot sizes of about 300 microns or larger and can be easily imaged by existing gel and blot scanners. The sample spot sizes in microarray can be 300 microns or less, but typically less than 200 microns in diameter and these arrays usually contains\ thousands of spots.
Microarrays require specialized robotics and/or imaging equipment that generally are not commercially available as a complete system. Terminologies that have been used in the literature to describe this technology include, but not limited to: biochip, DNA chip, DNA microarray, GENECHIP® (Affymetrix, Inc which refers to its high density,
oligonucleotide-based DNA arrays), and gene array.
DNA microarrays, or DNA chips are fabricated by high-speed robotics, generally on glass or nylon substrates, for which probes with known identity are used to determine complementary binding, thus allowing massively parallel gene expression and gene discovery studies. An experiment with a single DNA chip can provide information on thousands of genes simultaneously. It is herein contemplated that the disclosed microarrays
can be used to monitor gene expression, disease diagnosis, gene discovery, drug discovery (pharmacogenomics), and toxicological research or toxicogenomics.
There are two variants of the DNA microarray technology, in terms of the property of arrayed DNA sequence with known identity. Type I microarrays comprise a probe cDNA (500-5,000 bases long) that is immobilized to a solid surface such as glass using robot spotting and exposed to a set of targets either separately or in a mixture. This method is traditionally referred to as DNA microarray. With Type I microarrays, localized multiple copies of one or more polynucleotide sequences, preferably copies of a single
polynucleotide sequence are immobilized on a plurality of defined regions of the substrate's surface. A polynucleotide refers to a chain of nucleotides ranging from 5 to 10,000 nucleotides. These immobilized copies of a polynucleotide sequence are suitable for use as probes in hybridization experiments.
To prepare beads coated with immobilized probes, beads are immersed in a solution containing the desired probe sequence and then immobilized on the beads by covalent or non-covalent means. Alternatively, when the probes are immobilized on rods, a given probe can be spotted at defined regions of the rod. Typical dispensers include a micropipette delivering solution to the substrate with a robotic system to control the position of the micropipette with respect to the substrate. There can be a multiplicity of dispensers so that reagents can be delivered to the reaction regions simultaneously. In one embodiment, a microarray is formed by using ink-jet technology based on the piezoelectric effect, whereby a narrow tube containing a liquid of interest, such as oligonucleotide synthesis reagents, is encircled by an adapter. An electric charge sent across the adapter causes the adapter to expand at a different rate than the tube and forces a small drop of liquid onto a substrate.
Samples may be any sample containing polynucleotides (polynucleotide targets) of interest and obtained from any bodily fluid (blood, urine, saliva, phlegm, gastric juices, etc.), cultured cells, biopsies, or other tissue preparations. DNA or RNA can be isolated from the sample according to any of a number of methods well known to those of skill in the art. In one embodiment, total RNA is isolated using the TRIzol total RNA isolation
reagent (Life Technologies, Inc., Rockville, Md.) and RNA is isolated using oligo d(T) column chromatography or glass beads. After hybridization and processing, the
hybridization signals obtained should reflect accurately the amounts of control target polynucleotide added to the sample.
The plurality of defined regions on the substrate can be arranged in a variety of formats. For example, the regions may be arranged perpendicular or in parallel to the length of the casing. Furthermore, the targets do not have to be directly bound to the substrate, but rather can be bound to the substrate through a linker group. The linker groups may typically vary from about 6 to 50 atoms long. Linker groups include ethylene glycol oligomers, diamines, diacids and the like. Reactive groups on the substrate surface react with one of the terminal portions of the linker to bind the linker to the substrate. The other terminal portion of the linker is then functionalized for binding the probes.
Sample polynucleotides may be labeled with one or more labeling moieties to allow for detection of hybridized probe/target polynucleotide complexes. The labeling moieties can include compositions that can be detected by spectroscopic, photochemical, biochemical, bioelectronic, immunochemical, electrical, optical or chemical means. The
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labeling moieties include radioisotopes, such as JZP, or JJS, chemiluminescent compounds, labeled binding proteins, heavy metal atoms, spectroscopic markers, such as fluorescent markers and dyes, magnetic labels, linked enzymes, mass spectrometry tags, spin labels, electron transfer donors and acceptors, biotin, and the like.
Labeling can be carried out during an amplification reaction, such as polymerase chain reaction and in vitro or in vivo transcription reactions. Alternatively, the labeling moiety can be incorporated after hybridization once a probe-target complex his formed. In one embodiment, biotin is first incorporated during an amplification step as described above. After the hybridization reaction, unbound nucleic acids are rinsed away so that the only biotin remaining bound to the substrate is that attached to target polynucleotides that are hybridized to the polynucleotide probes. Then, an avidin-conjugated fluorophore, such as avidin-phycoerythrin, that binds with high affinity to biotin is added.
Hybridization causes a polynucleotide probe and a complementary target to form a stable duplex through base pairing. Hybridization methods are well known to those skilled in the art. Stringent conditions for hybridization can be defined by salt concentration, temperature, and other chemicals and conditions. Varying additional parameters, such as hybridization time, the concentration of detergent (sodium dodecyl sulfate, SDS) or solvent (formamide), and the inclusion or exclusion of carrier DNA, are well known to those skilled in the art. Additional variations on these conditions will be readily apparent to those skilled in the art.
Methods for detecting complex formation are well known to those skilled in the art. In one embodiment, the polynucleotide probes are labeled with a fluorescent label and measurement of levels and patterns of complex formation is accomplished by fluorescence microscopy, preferably confocal fluorescence microscopy. An argon ion laser excites the fluorescent label, emissions are directed to a photomultiplier and the amount of emitted light detected and quantitated. The detected signal should be proportional to the amount of probe/target polynucleotide complex at each position of the microarray. The fluorescence microscope can be associated with a computer-driven scanner device to generate a quantitative two-dimensional image of hybridization intensities. The scanned image is examined to determine the abundance/expression level of each hybridized target polynucleotide.
In a differential hybridization experiment, polynucleotide targets from two or more different biological samples are labeled with two or more different fluorescent labels with different emission wavelengths. Fluorescent signals are detected separately with different photomultipliers set to detect specific wavelengths. The relative abundances/expression levels of the target polynucleotides in two or more samples is obtained. Typically, microarray fluorescence intensities can be normalized to take into account variations in hybridization intensities when more than one microarray is used under similar test conditions. In one embodiment, individual polynucleotide probe/target complex
hybridization intensities are normalized using the intensities derived from internal normalization controls contained on each microarray.
Type II microarrays comprise an array of oligonucleotides (20~80-mer oligos) or peptide nucleic acid (PNA) probes that is synthesized either in situ (on-chip) or by conventional synthesis followed by on-chip immobilization. The array is exposed to labeled sample DNA, hybridized, and the identity/abundance of complementary sequences are determined. This method, "historically" called DNA chips, was developed at Affymetrix, Inc. , which sells its photolithographically fabricated products under the GENECHIP® trademark.
The basic concept behind the use of Type II arrays for gene expression is simple: labeled cDNA or cRNA targets derived from the mRNA of an experimental sample are hybridized to nucleic acid probes attached to the solid support. By monitoring the amount of label associated with each DNA location, it is possible to infer the abundance of each mRNA species represented. Although hybridization has been used for decades to detect and quantify nucleic acids, the combination of the miniaturization of the technology and the large and growing amounts of sequence information, have enormously expanded the scale at which gene expression can be studied.
Microarray manufacturing can begin with a 5 -inch square quartz wafer. Initially the quartz is washed to ensure uniform hydroxylation across its surface. Because quartz is naturally hydroxylated, it provides an excellent substrate for the attachment of chemicals, such as linker molecules, that are later used to position the probes on the arrays.
The wafer is placed in a bath of silane, which reacts with the hydroxyl groups of the quartz, and forms a matrix of covalently linked molecules. The distance between these silane molecules determines the probes' packing density, allowing arrays to hold over 500,000 probe locations, or features, within a mere 1.28 square centimeters. Each of these features harbors millions of identical DNA molecules. The silane film provides a uniform hydroxyl density to initiate probe assembly. Linker molecules, attached to the silane matrix, provide a surface that may be spatially activated by light.
Probe synthesis occurs in parallel, resulting in the addition of an A, C, T, or G nucleotide to multiple growing chains simultaneously. To define which oligonucleotide chains will receive a nucleotide in each step, photolithographic masks, carrying 18 to 20 square micron windows that correspond to the dimensions of individual features, are placed over the coated wafer. The windows are distributed over the mask based on the desired sequence of each probe. When ultraviolet light is shone over the mask in the first step of synthesis, the exposed linkers become deprotected and are available for nucleotide coupling.
Once the desired features have been activated, a solution containing a single type of deoxynucleotide with a removable protection group is flushed over the wafer's surface. The nucleotide attaches to the activated linkers, initiating the synthesis process.
Although each position in the sequence of an oligonucleotide can be occupied by lof Nucleotides, resulting in an apparent need for 25 x 4, or 100, different masks per wafer, the synthesis process can be designed to significantly reduce this requirement. Algorithms that help minimize mask usage calculate how to best coordinate probe growth by adjusting synthesis rates of individual probes and identifying situations when the same mask can be used multiple times.
Some of the key elements of selection and design are common to the production of all microarrays, regardless of their intended application. Strategies to optimize probe hybridization, for example, are invariably included in the process of probe selection.
Hybridization under particular pH, salt, and temperature conditions can be optimized by taking into account melting temperatures and using empirical rules that correlate with desired hybridization behaviors.
To obtain a complete picture of a gene's activity, some probes are selected from regions shared by multiple splice or polyadenylation variants. In other cases, unique probes that distinguish between variants are favored. Inter-probe distance is also factored into the selection process.
A different set of strategies is used to select probes for genotyping arrays that rely on multiple probes to interrogate individual nucleotides in a sequence. The identity of a target
base can be deduced using four identical probes that vary only in the target position, each containing one of the four possible bases.
Alternatively, the presence of a consensus sequence can be tested using one or two probes representing specific alleles. To genotype heterozygous or genetically mixed samples, arrays with many probes can be created to provide redundant information, resulting in unequivocal genotyping. In addition, generic probes can be used in some applications to maximize flexibility. Some probe arrays, for example, allow the separation and analysis of individual reaction products from complex mixtures, such as those used in some protocols to identify single nucleotide polymorphisms (SNPs).
Real-time PCR
Real-time PCR monitors the fluorescence emitted during the reaction as an indicator of amplicon production during each PCR cycle (i.e., in real time) as opposed to the endpoint detection. The real-time progress of the reaction can be viewed in some systems. Real-time PCR does not detect the size of the amplicon and thus does not allow the differentiation between DNA and cDNA amplification, however, it is not influenced by non-specific amplification unless SYBR Green is used. Real-time PCR quantitation eliminates post-PCR processing of PCR products. This helps to increase throughput and reduce the chances of carryover contamination. Real-time PCR also offers a wide dynamic range of up to 107-fold. Dynamic range of any assay determines how much target concentration can vary and still be quantified. A wide dynamic range means that a wide range of ratios of target and normaliser can be assayed with equal sensitivity and specificity. It follows that the broader the dynamic range, the more accurate the quantitation. When combined with RT-PCR, a real-time RT- PCR reaction reduces the time needed for measuring the amount of amplicon by providing for the visualization of the amplicon as the amplification process is progressing.
The real-time PCR system is based on the detection and quantitation of a fluorescent reporter. This signal increases in direct proportion to the amount of PCR product in a reaction. By recording the amount of fluorescence emission at each cycle, it is possible to monitor the PCR reaction during exponential phase where the first significant increase in
the amount of PCR product correlates to the initial amount of target template. The higher the starting copy number of the nucleic acid target, the sooner a significant increase in fluorescence is observed. A significant increase in fluorescence above the baseline value measured during the 3-15 cycles can indicate the detection of accumulated PCR product.
A fixed fluorescence threshold is set significantly above the baseline that can be altered by the operator. The parameter CT (threshold cycle) is defined as the cycle number at which the fluorescence emission exceeds the fixed threshold.
There are three main fluorescence-monitoring systems for DNA amplification: (1) hydrolysis probes; (2) hybridising probes; and (3) DNA-binding agents. Hydrolysis probes include TaqMan probes, molecular beacons and scorpions. They use the fluorogenic 5' exonuclease activity of Taq polymerase to measure the amount of target sequences in cDNA samples.
TaqMan probes are oligonucleotides longer than the primers (20-30 bases long with a Tm value of 10°C higher) that contain a fluorescent dye usually on the 5' base, and a quenching dye (usually TAMRA) typically on the 3' base. When irradiated, the excited fluorescent dye transfers energy to the nearby quenching dye molecule rather than fluorescing (this is called FRET = F5rster or fluorescence resonance energy transfer). Thus, the close proximity of the reporter and quencher prevents emission of any fluorescence while the probe is intact. TaqMan probes are designed to anneal to an internal region of a PCR product. When the polymerase replicates a template on which a TaqMan probe is bound, its 5' exonuclease activity cleaves the probe. This ends the activity of quencher (no FRET) and the reporter dye starts to emit fluorescence which increases in each cycle proportional to the rate of probe cleavage. Accumulation of PCR products is detected by monitoring the increase in fluorescence of the reporter dye (note that primers are not labelled). TaqMan assay uses universal thermal cycling parameters and PCR reaction conditions. Because the cleavage occurs only if the probe hybridises to the target, the origin of the detected fluorescence is specific amplification. The process of hybridisation and cleavage does not interfere with the exponential accumulation of the product. One specific
requirement for fluorogenic probes is that there be no G at the 5' end. A 'G' adjacent to the reporter dye can quench reporter fluorescence even after cleavage.
Molecular beacons also contain fluorescent (FAM, TAMRA, TET, ROX) and quenching dyes (typically DABCYL) at either end but they are designed to adopt a hairpin structure while free in solution to bring the fluorescent dye and the quencher in close proximity for FRET to occur. They have two arms with complementary sequences that form a very stable hybrid or stem. The close proximity of the reporter and the quencher in this hairpin configuration suppresses reporter fluorescence. When the beacon hybridises to the target during the annealing step, the reporter dye is separated from the quencher and the reporter fluoresces (FRET does not occur). Molecular beacons remain intact during PCR and must rebind to target every cycle for fluorescence emission. This will correlate to the amount of PCR product available. All real-time PCR chemistries allow detection of multiple DNA species (multiplexing) by designing each probe/beacon with a spectrally unique fluor/quench pair as long as the platform is suitable for melting curve analysis if SYBR green is used. By multiplexing, the target(s) and endogenous control can be amplified in single tube.
With Scorpion probes, sequence-specific priming and PCR product detection is achieved using a single oligonucleotide. The Scorpion probe maintains a stem-loop configuration in the unhybridised state. The fluorophore is attached to the 5' end and is quenched by a moiety coupled to the 3' end. The 3' portion of the stem also contains sequence that is complementary to the extension product of the primer. This sequence is linked to the 5' end of a specific primer via a non-amplifiable monomer. After extension of the Scorpion primer, the specific probe sequence is able to bind to its complement within the extended amplicon thus opening up the hairpin loop. This prevents the fluorescence from being quenched and a signal is observed.
Another alternative is the double-stranded DNA binding dye chemistry, which quantitates the amplicon production (including non-specific amplification and primer-dimer complex) by the use of a non-sequence specific fluorescent intercalating agent (SYBR-
green I or ethidium bromide). It does not bind to ssDNA. SYBR green is a fluorogenic minor groove binding dye that exhibits little fluorescence when in solution but emits a strong fluorescent signal upon binding to double-stranded DNA. Disadvantages of SYBR green-based real-time PCR include the requirement for extensive optimisation. Furthermore, non-specific amplifications require follow-up assays (melting point curve or dissociation analysis) for amplicon identification. The method has been used in HFE-C282Y genotyping. Another controllable problem is that longer amplicons create a stronger signal (if combined with other factors, this may cause CDC camera saturation, see below). Normally SYBR green is used in singleplex reactions, however when coupled with melting point analysis, it can be used for multiplex reactions.
The threshold cycle or the CT value is the cycle at which a significant increase in ARn is first detected (for definition of ARn, see below). The threshold cycle is when the system begins to detect the increase in the signal associated with an exponential growth of PCR product during the log-linear phase. This phase provides the most useful information about the reaction (certainly more important than the end-point). The slope of the log-linear phase is a reflection of the amplification efficiency. The efficiency (Eff) of the reaction can be calculated by the formula: Eff=10( 1/slope)-l . The efficiency of the PCR should be 90 - 100% (3.6 > slope >3.1). A number of variables can affect the efficiency of the PCR. These factors include length of the amplicon, secondary structure and primer quality. Although valid data can be obtained that fall outside of the efficiency range, the qRT-PCR should be further optimised or alternative amplicons designed. For the slope to be an indicator of real amplification (rather than signal drift), there has to be an inflection point. This is the point on the growth curve when the log-linear phase begins. It also represents the greatest rate of change along the growth curve. (Signal drift is characterised by gradual increase or decrease in fluorescence without amplification of the product.) The important parameter for quantitation is the CT. The higher the initial amount of genomic DNA, the sooner accumulated product is detected in the PCR process, and the lower the CT value. The threshold should be placed above any baseline activity and within the exponential increase
phase (which looks linear in the log transformation). Some software allows determination of the cycle threshold (CT) by a mathematical analysis of the growth curve. This provides better run-to-run reproducibility. A CT value of 40 means no amplification and this value cannot be included in the calculations. Besides being used for quantitation, the CT value can be used for qualitative analysis as a pass/fail measure.
Multiplex TaqMan assays can be performed using multiple dyes with distinct emission wavelengths. Available dyes for this purpose are FAM, TET, VIC and JOE (the most expensive). TAMRA is reserved as the quencher on the probe and ROX as the passive reference. For best results, the combination of FAM (target) and VIC (endogenous control) is recommended (they have the largest difference in emission maximum) whereas JOE and VIC should not be combined. It is important that if the dye layer has not been chosen correctly, the machine will still read the other dye's spectrum. For example, both VIC and FAM emit fluorescence in a similar range to each other and when doing a single dye, the wells should be labelled correctly. In the case of multiplexing, the spectral compensation for the post run analysis should be turned on (on ABI 7700: Instrument/Diagnostics/Advanced Options/Miscellaneous). Activating spectral compensation improves dye spectral resolution.
Nested PCR
The disclosed methods can further utilize nested PCR. Nested PCR increases the specificity of DNA amplification, by reducing background due to non-specific amplification of DNA. Two sets of primers are being used in two successive PCRs. In the first reaction, one pair of primers is used to generate DNA products, which besides the intended target, may still consist of non-specifically amplified DNA fragments. The product(s) are then used in a second PCR with a set of primers whose binding sites are completely or partially different from and located 3' of each of the primers used in the first reaction. Nested PCR is often more successful in specifically amplifying long DNA fragments than conventional PCR, but it requires more detailed knowledge of the target sequences.
Primers and Probes
The disclosed methods and assays can use primers and probes. As used herein, "primers" are a subset of probes which are capable of supporting some type of enzymatic manipulation and which can hybridize with a target nucleic acid such that the enzymatic manipulation can occur. A primer can be made from any combination of nucleotides or nucleotide derivatives or analogs available in the art which do not interfere with the enzymatic manipulation.
As used herein, "probes" are molecules capable of interacting with a target nucleic acid, typically in a sequence specific manner, for example through hybridization. The hybridization of nucleic acids is well understood in the art and discussed herein. Typically a probe can be made from any combination of nucleotides or nucleotide derivatives or analogs available in the art.
Disclosed are assays and methods which include the use of primers and probes, as well as, the disclosed primer panels all of which are capable of interacting with the disclosed nucleic acids such as ALK (SEQ ID NO: 1), BRAF, EGFR, KIT, or KRAS or their complement. For example, any of the primers or primer sets from Table 7-14 can be used in the disclosed primer panels or any of the methods and assays disclosed herein. In certain embodiments the primers are used to support nucleic acid extension reactions, nucleic acid replication reactions, and/or nucleic acid amplification reactions. Typically the primers will be capable of being extended in a sequence specific manner. Extension of a primer in a sequence specific manner includes any methods wherein the sequence and/or composition of the nucleic acid molecule to which the primer is hybridized or otherwise associated directs or influences the composition or sequence of the product produced by the extension of the primer. Extension of the primer in a sequence specific manner therefore includes, but is not limited to, PCR, DNA sequencing, DNA extension, DNA polymerization, RNA transcription, or reverse transcription. Techniques and conditions that amplify the primer in a sequence specific manner are disclosed. In certain embodiments the primers are used for the DNA amplification reactions, such as PCR or direct sequencing. It is understood that in certain embodiments the primers can also be extended using non-enzymatic techniques,
where for example, the nucleotides or oligonucleotides used to extend the primer are modified such that they will chemically react to extend the primer in a sequence specific manner. Typically the disclosed primers hybridize with the disclosed nucleic acids or region of the nucleic acids or they hybridize with the complement of the nucleic acids or complement of a region of the nucleic acids. As an example of the use of primers, one or more primers can be used to create extension products from and templated by a first nucleic acid.
The size of the primers or probes for interaction with the nucleic acids can be any size that supports the desired enzymatic manipulation of the primer, such as DNA amplification or the simple hybridization of the probe or primer. A typical primer or probe would be at least 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, 1000, 1250, 1500, 1750, 2000, 2250, 2500, 2750, 3000, 3500, or 4000 nucleotides long.
In other embodiments a primer or probe can be less than or equal to 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, 1000, 1250, 1500, 1750, 2000, 2250, 2500, 2750, 3000, 3500, or 4000 nucleotides long.
The primers for the nucleic acid of interest typically will be used to produce extension products and/or other replicated or amplified products that contain a region of the
nucleic acid of interest. The size of the product can be such that the size can be accurately determined to within 3, or 2 or 1 nucleotides.
In certain embodiments the product can be, for example, at least 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, 1000, 1250, 1500, 1750, 2000, 2250, 2500, 2750, 3000, 3500, or 4000 nucleotides long.
In other embodiments the product can be, for example, less than or equal to 20, 21,
22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 125, 150, 175, 200, 225, 250, 275, 300, 325, 350, 375, 400, 425, 450, 475, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950, 1000, 1250, 1500, 1750, 2000, 2250, 2500, 2750, 3000, 3500, or 4000 nucleotides long.
It is understood and herein contemplated that there are situations where it may be advantageous to utilize more than one primer pair to detect the presence of mutations conferring inhibitor resistance in EGFR, BRAF, KIT, KRAS, or ALK. Such RT-PCR, real- time PCT or other PCR reactions can be conducted separately, or in a single reaction.
When multiple primer pairs are placed into a single reaction, this is referred to as "multiplex PCR." It is understood and herein contemplated that any combination of two or more or three or more the forward and/or reverse primers disclosed herein can be used in the multiplex reaction.
Fluorescent Change Probes and Primers
Fluorescent change probes and fluorescent change primers refer to all probes and primers that involve a change in fluorescence intensity or wavelength based on a change in the form or conformation of the probe or primer and nucleic acid to be detected, assayed or
replicated. Examples of fluorescent change probes and primers include molecular beacons, Amplifluors, FRET probes, cleavable FRET probes, TaqMan probes, scorpion primers, fluorescent triplex oligos including but not limited to triplex molecular beacons or triplex FRET probes, fluorescent water-soluble conjugated polymers, PNA probes and QPNA probes.
Fluorescent change probes and primers can be classified according to their structure and/or function. Fluorescent change probes include hairpin quenched probes, cleavage quenched probes, cleavage activated probes, and fluorescent activated probes. Fluorescent change primers include stem quenched primers and hairpin quenched primers.
Hairpin quenched probes are probes that when not bound to a target sequence form a hairpin structure (and, typically, a loop) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched. When the probe binds to a target sequence, the stem is disrupted, the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases. Examples of hairpin quenched probes are molecular beacons, fluorescent triplex oligos, triplex molecular beacons, triplex FRET probes, and QPNA probes.
Cleavage activated probes are probes where fluorescence is increased by cleavage of the probe. Cleavage activated probes can include a fluorescent label and a quenching moiety in proximity such that fluorescence from the label is quenched. When the probe is clipped or digested (typically by the 5'-3' exonuclease activity of a polymerase during amplification), the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases. TaqMan probes are an example of cleavage activated probes.
Cleavage quenched probes are probes where fluorescence is decreased or altered by cleavage of the probe. Cleavage quenched probes can include an acceptor fluorescent label and a donor moiety such that, when the acceptor and donor are in proximity, fluorescence resonance energy transfer from the donor to the acceptor causes the acceptor to fluoresce. The probes are thus fluorescent, for example, when hybridized to a target sequence. When the probe is clipped or digested (typically by the 5'-3' exonuclease activity of a polymerase
during amplification), the donor moiety is no longer in proximity to the acceptor fluorescent label and fluorescence from the acceptor decreases. If the donor moiety is itself a fluorescent label, it can release energy as fluorescence (typically at a different wavelength than the fluorescence of the acceptor) when not in proximity to an acceptor. The overall effect would then be a reduction of acceptor fluorescence and an increase in donor fluorescence. Donor fluorescence in the case of cleavage quenched probes is equivalent to fluorescence generated by cleavage activated probes with the acceptor being the quenching moiety and the donor being the fluorescent label. Cleavable FRET (fluorescence resonance energy transfer) probes are an example of cleavage quenched probes.
Fluorescent activated probes are probes or pairs of probes where fluorescence is increased or altered by hybridization of the probe to a target sequence. Fluorescent activated probes can include an acceptor fluorescent label and a donor moiety such that, when the acceptor and donor are in proximity (when the probes are hybridized to a target sequence), fluorescence resonance energy transfer from the donor to the acceptor causes the acceptor to fluoresce. Fluorescent activated probes are typically pairs of probes designed to hybridize to adjacent sequences such that the acceptor and donor are brought into proximity. Fluorescent activated probes can also be single probes containing both a donor and acceptor where, when the probe is not hybridized to a target sequence, the donor and acceptor are not in proximity but where the donor and acceptor are brought into proximity when the probe hybridized to a target sequence. This can be accomplished, for example, by placing the donor and acceptor on opposite ends of the probe and placing target complement sequences at each end of the probe where the target complement sequences are complementary to adjacent sequences in a target sequence. If the donor moiety of a fluorescent activated probe is itself a fluorescent label, it can release energy as fluorescence (typically at a different wavelength than the fluorescence of the acceptor) when not in proximity to an acceptor (that is, when the probes are not hybridized to the target sequence). When the probes hybridize to a target sequence, the overall effect would then be a reduction of donor
fluorescence and an increase in acceptor fluorescence. FRET probes are an example of fluorescent activated probes.
Stem quenched primers are primers that when not hybridized to a complementary sequence form a stem structure (either an intramolecular stem structure or an intermolecular stem structure) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched. When the primer binds to a complementary sequence, the stem is disrupted; the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases. In the disclosed method, stem quenched primers are used as primers for nucleic acid synthesis and thus become incorporated into the synthesized or amplified nucleic acid. Examples of stem quenched primers are peptide nucleic acid quenched primers and hairpin quenched primers.
Peptide nucleic acid quenched primers are primers associated with a peptide nucleic acid quencher or a peptide nucleic acid fluor to form a stem structure. The primer contains a fluorescent label or a quenching moiety and is associated with either a peptide nucleic acid quencher or a peptide nucleic acid fluor, respectively. This puts the fluorescent label in proximity to the quenching moiety. When the primer is replicated, the peptide nucleic acid is displaced, thus allowing the fluorescent label to produce a fluorescent signal.
Hairpin quenched primers are primers that when not hybridized to a complementary sequence form a hairpin structure (and, typically, a loop) that brings a fluorescent label and a quenching moiety into proximity such that fluorescence from the label is quenched. When the primer binds to a complementary sequence, the stem is disrupted; the quenching moiety is no longer in proximity to the fluorescent label and fluorescence increases. Hairpin quenched primers are typically used as primers for nucleic acid synthesis and thus become incorporated into the synthesized or amplified nucleic acid. Examples of hairpin quenched primers are Amplifluor primers and scorpion primers.
Cleavage activated primers are similar to cleavage activated probes except that they are primers that are incorporated into replicated strands and are then subsequently cleaved.
Labels
To aid in detection and quantitation of nucleic acids produced using the disclosed methods, labels can be directly incorporated into nucleotides and nucleic acids or can be coupled to detection molecules such as probes and primers. As used herein, a label is any molecule that can be associated with a nucleotide or nucleic acid, directly or indirectly, and which results in a measurable, detectable signal, either directly or indirectly. Many such labels for incorporation into nucleotides and nucleic acids or coupling to nucleic acid probes are known to those of skill in the art. Examples of labels suitable for use in the disclosed method are radioactive isotopes, fluorescent molecules, phosphorescent molecules, enzymes, antibodies, and ligands. Fluorescent labels, especially in the context of fluorescent change probes and primers, are useful for real-time detection of amplification.
Examples of suitable fluorescent labels include fluorescein isothiocyanate (FITC), 5,6-carboxymethyl fluorescein, Texas red, nitrobenz-2-oxa-l,3-diazol-4-yl ( BD), coumarin, dansyl chloride, rhodamine, amino-methyl coumarin (AMCA), Eosin, Erythrosin, BODIPY®, CASCADE BLUE®, OREGON GREEN®, pyrene, lissamine, xanthenes, acridines, oxazines, phycoerythrin, macrocyclic chelates of lanthanide ions such as quantum dye™, fluorescent energy transfer dyes, such as thiazole orange-ethidium heterodimer, and the cyanine dyes Cy3, Cy3.5, Cy5, Cy5.5 and Cy7. Examples of other specific fluorescent labels include 3-Hydroxypyrene 5,8,10-Tri Sulfonic acid, 5-Hydroxy Tryptamine (5-HT), Acid Fuchsin, Alizarin Complexon, Alizarin Red, Allophycocyanin, Aminocoumarin, Anthroyl Stearate, Astrazon Brilliant Red 4G, Astrazon Orange R, Astrazon Red 6B, Astrazon Yellow 7 GLL, Atabrine, Auramine, Aurophosphine, Aurophosphine G, BAO 9 (Bisaminophenyloxadiazole), BCECF, BerberineSulphate, Bisbenzamide, Blancophor FFG Solution, Blancophor SV, Bodipy Fl, Brilliant Sulpho flavin FF, Calcien Blue, Calcium Green, Calcofluor RW Solution, Calcofluor White, Calcophor White ABT Solution, Calcophor White Standard Solution, Carbostyryl, Cascade Yellow, Catecholamine, Chinacrine, Coriphosphine O, Coumarin-Phalloidin, CY3.1 8, CY5.1 8, CY7, Dans (1- Dimethyl Amino Naphaline 5 Sulphonic Acid), Dansa (DiaminoNaphtylSulphonic Acid),
Dansyl NH-CH3, Diamino Phenyl Oxydiazole (DAO), Dimethylamino-5-Sulphonic acid, DipyrrometheneboronDifluoride, Diphenyl Brilliant Flavine 7GFF, Dopamine, Erythrosin ITC, Euchrysin, FIF (Formaldehyde Induced Fluorescence), Flazo Orange, Fluo 3, Fluorescamine, Fura-2, Genacryl Brilliant Red B, Genacryl Brilliant Yellow 10GF, Genacryl Pink 3G, Genacryl Yellow 5GF, Gloxalic Acid, Granular Blue,
Haematoporphyrin, Indo-1, IntrawhiteCf Liquid, Leucophor PAF, Leucophor SF,
Leucophor WS, LissamineRhodamine B200 (RD200), Lucifer Yellow CH, Lucifer Yellow VS, Magdala Red, Marina Blue, Maxilon Brilliant Flavin 10 GFF, Maxilon Brilliant Flavin 8 GFF, MPS (Methyl Green PyronineStilbene), Mithramycin, NBD Amine,
Nitrobenzoxadidole, Noradrenaline, Nuclear Fast Red, Nuclear Yellow, Nylosan Brilliant Flavin E8G, Oxadiazole, Pacific Blue, Pararosaniline (Feulgen), Phorwite AR Solution, Phorwite BKL, Phorwite Rev, Phorwite RPA, Phosphine 3R, Phthalocyanine,
Phycoerythrin R, Phycoerythrin B, PolyazaindacenePontochrome Blue Black, Porphyrin, Primuline, Procion Yellow, Pyronine, Pyronine B, Pyrozal Brilliant Flavin 7GF, Quinacrine Mustard, Rhodamine 123, Rhodamine 5 GLD, Rhodamine 6G, Rhodamine B, Rhodamine B 200, Rhodamine B Extra, Rhodamine BB, Rhodamine BG, Rhodamine WT, Serotonin, Sevron Brilliant Red 2B, Sevron Brilliant Red 4G, Sevron Brilliant Red B, Sevron Orange, Sevron Yellow L, SITS (Primuline), SITS (Stilbenelsothiosulphonic acid), Stilbene, Snarf 1, sulphoRhodamine B Can C, SulphoRhodamine G Extra, Tetracycline, Thiazine Red R, Thioflavin S, Thioflavin TCN, Thioflavin 5, Thiolyte, Thiozol Orange, Tinopol CBS, True Blue, Ultralite, Uranine B, Uvitex SFC, Xylene Orange, and XRITC.
The absorption and emission maxima, respectively, for some of these fluors are: FITC (490 nm; 520 nm), Cy3 (554 nm; 568 nm), Cy3.5 (581 nm; 588 nm), Cy5 (652 nm: 672 nm), Cy5.5 (682 nm; 703 nm) and Cy7 (755 nm; 778 nm), thus allowing their simultaneous detection. Other examples of fluorescein dyes include 6-carboxyfluorescein (6-FAM), 2',4',1,4,-tetrachlorofluorescein (TET), 2',4',5',7',1,4-hexachlorofluorescein (HEX), 2',7'-dimethoxy-4', 5'-dichloro-6-carboxyrhodamine (JOE), 2'-chloro-5'-fluoro-7',8'- fused phenyl- l,4-dichloro-6-carboxyfluorescein (NED), and 2'-chloro-7'-phenyl-l,4-
dichloro-6-carboxyfluorescein (VIC). Fluorescent labels can be obtained from a variety of commercial sources, including Amersham Pharmacia Biotech, Piscataway, NJ; Molecular Probes, Eugene, OR; and Research Organics, Cleveland, Ohio.
Additional labels of interest include those that provide for signal only when the probe with which they are associated is specifically bound to a target molecule, where such labels include: "molecular beacons" as described in Tyagi& Kramer, Nature Biotechnology (1996) 14:303 and EP 0 070 685 B l. Other labels of interest include those described in U.S. Pat. No. 5,563,037 which is incorporated herein by reference.
Labeled nucleotides are a form of label that can be directly incorporated into the amplification products during synthesis. Examples of labels that can be incorporated into amplified nucleic acids include nucleotide analogs such as BrdUrd, aminoallyldeoxyuridine, 5-methylcytosine, bromouridine, and nucleotides modified with biotin or with suitable haptens such as digoxygenin. Suitable fluorescence-labeled nucleotides are Fluorescein- isothiocyanate-dUTP, Cyanine-3-dUTP and Cyanine-5-dUTP. One example of a nucleotide analog label for DNA is BrdUrd (bromodeoxyuridine, BrdUrd, BrdU, BUdR, Sigma- Aldrich Co). Other examples of nucleotide analogs for incorporation of label into DNA are AA-dUTP (aminoallyl-deoxyuridine triphosphate, Sigma-Aldrich Co.), and 5-methyl-dCTP (Roche Molecular Biochemicals). One example of a nucleotide analog for incorporation of label into RNA is biotin- 16-UTP (biotin- 16-uridine-5'-triphosphate, Roche Molecular Biochemicals). Fluorescein, Cy3, and Cy5 can be linked to dUTP for direct labeling.
Cy3.5 and Cy7 are available as avidin or anti-digoxygenin conjugates for secondary detection of biotin- or digoxygenin-labeled probes.
Labels that are incorporated into amplified nucleic acid, such as biotin, can be subsequently detected using sensitive methods well-known in the art. For example, biotin can be detected using streptavidin-alkaline phosphatase conjugate (Tropix, Inc.), which is bound to the biotin and subsequently detected by chemiluminescence of suitable substrates (for example, chemiluminescent substrate CSPD: disodium, 3-(4-methoxyspiro-[l,2,- dioxetane-3-2'-(5'-chloro)tricyclo [3.3.1.13'7]decane]-4-yl) phenyl phosphate; Tropix, Inc.).
Labels can also be enzymes, such as alkaline phosphatase, soybean peroxidase, horseradish peroxidase and polymerases, that can be detected, for example, with chemical signal amplification or by using a substrate to the enzyme which produces light (for example, a chemiluminescent 1 ,2-dioxetane substrate) or fluorescent signal.
Molecules that combine two or more of these labels are also considered labels. Any of the known labels can be used with the disclosed probes, tags, and method to label and detect nucleic acid amplified using the disclosed method. Methods for detecting and measuring signals generated by labels are also known to those of skill in the art. For example, radioactive isotopes can be detected by scintillation counting or direct visualization; fluorescent molecules can be detected with fluorescent spectrophotometers; phosphorescent molecules can be detected with a spectrophotometer or directly visualized with a camera; enzymes can be detected by detection or visualization of the product of a reaction catalyzed by the enzyme; antibodies can be detected by detecting a secondary label coupled to the antibody. As used herein, detection molecules are molecules which interact with amplified nucleic acid and to which one or more labels are coupled.
The disclosed methods, assays, and primer panels can be used to diagnose any disease where uncontrolled cellular proliferation occurs herein referred to as "cancer". A non-limiting list of different types of ALK related cancers is as follows: lymphomas (Hodgkins and non-Hodgkins), leukemias, carcinomas, carcinomas of solid tissues, squamous cell carcinomas, adenocarcinomas, sarcomas, gliomas, high grade gliomas, blastomas, neuroblastomas, plasmacytomas, histiocytomas, melanomas, adenomas, hypoxic tumours, myelomas, AIDS-related lymphomas or sarcomas, metastatic cancers, or cancers in general. In particular, the disclosed methods, assays, and kits relate to the diagnosis, detection, or prognosis of inflammatory breast cancer
A representative but non-limiting list of cancers that the disclosed methods can be used to diagnose is the following: lymphoma, B cell lymphoma (including diffuse large B-cell lymphoma), B-cell plasmablastic/immunoblastic lymphomas, T cell lymphoma (including T- or null-cell lymphomas), mycosis fungoides, Hodgkin's Disease, myeloid leukemia,
bladder cancer, brain cancer, nervous system cancer, head and neck cancer, squamous cell carcinoma of head and neck, kidney cancer, lung cancers such as small cell lung cancer and non-small cell lung cancer, neuroblastoma/glioblastoma, , anaplastic large-cell lymphoma (ALCL), inflammatory myofibroblastic tumors, ovarian cancer, pancreatic cancer, prostate cancer, skin cancer, liver cancer, melanoma, malignant histiocytosis, squamous cell carcinomas of the mouth, throat, larynx, and lung, colon cancer, cervical cancer, cervical carcinoma, breast cancer (including inflammatory breast cancer), and epithelial cancer, renal cancer, genitourinary cancer, pulmonary cancer, esophageal squamous cell carcinoma, head and neck carcinoma, large bowel cancer, hematopoietic cancers; testicular cancer; colon and rectal cancers, prostatic cancer, or pancreatic cancer.
Nucleic Acids
The disclosed method and compositions make use of various nucleic acids.
Generally, any nucleic acid can be used in the disclosed method. For example, the disclosed nucleic acids of interest and the disclosed reference nucleic acids can be chosen based on the desired analysis and information that is to be obtained or assessed. The disclosed methods also produce new and altered nucleic acids. The nature and structure of such nucleic acids will be established by the manner in which they are produced and manipulated in the methods. Thus, for example, extension products and hybridizing nucleic acids are produced in the disclosed methods. As used herein, hybridizing nucleic acids are hybrids of extension products and the second nucleic acid.
It is understood and contemplated herein that a nucleic acid of interest can be any nucleic acid to which the determination of the presence or absence of nucleotide variation is desired. Thus, for example, the nucleic acid of interest can comprise a sequence that corresponds to the wild-type sequence of the reference nucleic acid. It is further disclosed herein that the disclosed methods can be performed where the first nucleic acid is a reference nucleic acid and the second nucleic acid is a nucleic acid of interest or where the first nucleic acid is the nucleic acid of interest and the second nucleic acid is the reference nucleic acid.
It is understood and herein contemplated that a reference nucleic acid can be any nucleic acid against which a nucleic acid of interest is to be compared. Typically, the reference nucleic acid has a known sequence (and/or is known to have a sequence of interest as a reference). Although not required, it is useful if the reference sequence has a known or suspected close relationship to the nucleic acid of interest. For example, if a single nucleotide variation is desired to be detected, the reference sequence can be usefully chosen to be a sequence that is a homolog or close match to the nucleic acid of interest, such as a nucleic acid derived from the same gene or genetic element from the same or a related organism or individual. Thus, for example, it is contemplated herein that the reference nucleic acid can comprise a wild-type sequence or alternatively can comprise a known mutation including, for example, a mutation the presence or absence of which is associated with a disease or resistance to therapeutic treatment. Thus, for example, it is contemplated that the disclosed methods can be used to detect or diagnose the presence of known mutations in a nucleic acid of interest by comparing the nucleic acid of interest to a reference nucleic acid that comprises a wild-type sequence (i.e., is known not to possess the mutation) and examining for the presence or absence of variation in the nucleic acid of interest, where the absence of variation would indicate the absence of a mutation.
Alternatively, the reference nucleic acid can possess a known mutation. Thus, for example, it is contemplated that the disclosed methods can be used to detect susceptibility for a disease or condition by comparing the nucleic acid of interest to a reference nucleic acid comprising a known mutation that indicates susceptibility for a disease and examining for the presence or absence of the mutation, wherein the presence of the mutation indicates a disease.
Herein, the term "nucleotide variation" refers to any change or difference in the nucleotide sequence of a nucleic acid of interest relative to the nucleotide sequence of a reference nucleic acid. Thus, a nucleotide variation is said to occur when the sequences between the reference nucleic acid and the nucleic acid of interest (or its complement, as appropriate in context) differ. Thus, for example, a substitution of an adenine (A) to a
guanine (G) at a particular position in a nucleic acid would be a nucleotide variation provided the reference nucleic acid comprised an A at the corresponding position. It is understood and herein contemplated that the determination of a variation is based upon the reference nucleic acid and does not indicate whether or not a sequence is wild-type. Thus, for example, when a nucleic acid with a known mutation is used as the reference nucleic acid, a nucleic acid not possessing the mutation (including a wild-type nucleic acid) would be considered to possess a nucleotide variation (relative to the reference nucleic acid). Nucleotides
The disclosed methods and compositions make use of various nucleotides.
Throughout this application and the methods disclosed herein reference is made to the type of base for a nucleotide. It is understood and contemplated herein that where reference is made to a type of base, this refers a base that in a nucleotide in a nucleic acid strand is capable of hybridizing (binding) to a defined set of one or more of the canonical bases. Thus, for example, where reference is made to extension products extended in the presence of three types of nuclease resistant nucleotides and not in the presence of nucleotides that comprise the same type of base as the modified nucleotides, this means that if, for example, the base of the modified nucleotide was an adenine (A), the nuclease-resistant nucleotides can be, for example, guanine (G), thymine (T), and cytosine (C). Each of these bases (which represent the four canonical bases) is capable of hybridizing to a different one of the four canonical bases and thus each qualify as a different type of base as defined herein. As another example, inosine base pairs primarily with adenine and cytosine (in DNA) and thus can be considered a different type of base from adenine and from cytosine- which base pair with thymine and guanine, respectively-but not a different type of base from guanine or thymine-which base pair with cytosine and adenine, respectively-because the base pairing of guanine and thymine overlaps (that is, is not different from) the hybridization pattern of inosine.
Any type of modified or alternative base can be used in the disclosed methods and compositions, generally limited only by the capabilities of the enzymes used to use such
bases. Many modified and alternative nucleotides and bases are known, some of which are described below and elsewhere herein. The type of base that such modified and alternative bases represent can be determined by the pattern of base pairing for that base as described herein. Thus for example, if the modified nucleotide was adenine, any analog, derivative, modified, or variant base that based pairs primarily with thymine would be considered the same type of base as adenine. In other words, so long as the analog, derivative, modified, or variant has the same pattern of base pairing as another base, it can be considered the same type of base. Modifications can made to the sugar or phosphate groups of a nucleotide. Generally such modifications will not change the base pairing pattern of the base.
However, the base pairing pattern of a nucleotide in a nucleic acid strand determines the type of base of the base in the nucleotide.
Modified nucleotides to be incorporated into extension products and to be selectively removed by the disclosed agents in the disclosed methods can be any modified nucleotide that functions as needed in the disclosed method as is described elsewhere herein. Modified nucleotides can also be produced in existing nucleic acid strands, such as extension products, by, for example, chemical modification, enzymatic modification, or a combination.
Many types of nuclease-resistant nucleotides are known and can be used in the disclosed methods. For example, nucleotides have modified phosphate groups and/or modified sugar groups can be resistant to one or more nucleases. Nuclease-resistance is defined herein as resistance to removal from a nucleic acid by any one or more nucleases. Generally, nuclease resistance of a particular nucleotide can be defined in terms of a relevant nuclease. Thus, for example, if a particular nuclease is used in the disclosed method, the nuclease-resistant nucleotides need only be resistant to that particular nuclease. Examples of useful nuclease-resistant nucleotides include thio-modified nucleotides and borano-modified nucleotides.
There are a variety of molecules disclosed herein that are nucleic acid based. Non- limiting examples of these and other molecules are discussed herein. It is understood that
for example, a nucleotide is a molecule that contains a base moiety, a sugar moiety and a phosphate moiety. Nucleotides can be linked together through their phosphate moieties and sugar moieties creating an internucleoside linkage. The base moiety of a nucleotide can be adenine-9-yl (adenine, A), cytosine- 1-yl (cytosine, C), guanine-9-yl (guanine, G), uracil- 1- yl (uracil, U), and thymin-l-yl (thymine, T). The sugar moiety of a nucleotide is a ribose or a deoxyribose. The phosphate moiety of a nucleotide is pentavalent phosphate. A non- limiting example of a nucleotide would be 3'-AMP (3'-adenosine monophosphate) or 5'- GMP (5'-guanosine monophosphate).
A nucleotide analog is a nucleotide which contains some type of modification to either the base, sugar, or phosphate moieties. Modifications to the base moiety would include natural and synthetic modifications of A, C, G, and T/U as well as different purine or pyrimidine bases, such as uracil-5-yl (ψ), hypoxanthin-9-yl (inosine, I), and 2- aminoadenin-9-yl. A modified base includes but is not limited to 5-methylcytosine (5-me- C), 5-hydroxymethyl cytosine, xanthine, hypoxanthine, 2-aminoadenine, 6-methyl and other alkyl derivatives of adenine and guanine, 2-propyl and other alkyl derivatives of adenine and guanine, 2-thiouracil, 2-thiothymine and 2-thiocytosine, 5-halouracil and cytosine, 5- propynyl uracil and cytosine, 6-azo uracil, cytosine and thymine, 5 -uracil (pseudouracil), 4- thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioalkyl, 8-hydroxyl and other 8-substituted adenines and guanines, 5-halo particularly 5-bromo, 5-trifluoromethyl and other 5-substituted uracils and cytosines, 7-methylguanine and 7-methyladenine, 8-azaguanine and 8-azaadenine, 7- deazaguanine and 7-deazaadenine and 3-deazaguanine and 3-deazaadenine. Additional base modifications can be found for example in U.S. Pat. No. 3,687,808, which is incorporated herein in its entirety for its teachings of base modifications. Certain nucleotide analogs, such as 5-substituted pyrimidines, 6-azapyrimidines and N-2, N-6 and 0-6 substituted purines, including 2-aminopropyladenine, 5-propynyluracil and 5- propynylcytosine. 5-methylcytosine can increase the stability of duplex formation. Often time base modifications can be combined with for example a sugar modification, such as 2'- O-methoxyethyl, to achieve unique properties such as increased duplex stability.
Nucleotide analogs can also include modifications of the sugar moiety.
Modifications to the sugar moiety would include natural modifications of the ribose and deoxy ribose as well as synthetic modifications. Sugar modifications include but are not limited to the following modifications at the 2' position: OH; F; 0-, S-, or N-alkyl; 0-, S-, or N-alkenyl; 0-, S-or N-alkynyl; or O-alkyl-O-alkyl, wherein the alkyl, alkenyl and alkynyl may be substituted or unsubstituted CI to CIO, alkyl or C2 to CIO alkenyl and alkynyl. 2' sugar modifications also include but are not limited to -0[(CH2)n 0]m CH3, - 0(CH2)n 0CH3, -0(CH2)n NH2, -0(CH2)n CH3, -0(CH2)n -0NH2, and - 0(CH2)nON[(CH2)n CH3)]2, where n and m are from 1 to about 10.
Other modifications at the 2' position include but are not limited to: CI to CIO lower alkyl, substituted lower alkyl, alkaryl, aralkyl, O-alkaryl or O-aralkyl, SH, SCH3, OCN, CI, Br, CN, CF3, OCF3, SOCH3, S02 CH3, ON02, N02, N3, NH2, heterocycloalkyl, heterocycloalkaryl, aminoalkylamino, polyalkylamino, substituted silyl, an RNA cleaving group, a reporter group, an intercalator, a group for improving the pharmacokinetic properties of an oligonucleotide, or a group for improving the pharmacodynamic properties of an oligonucleotide, and other substituents having similar properties. Similar
modifications may also be made at other positions on the sugar, particularly the 3' position of the sugar on the 3' terminal nucleotide or in 2'-5' linked oligonucleotides and the 5' position of 5' terminal nucleotide. Modified sugars would also include those that contain modifications at the bridging ring oxygen, such as CH2 and S. Nucleotide sugar analogs may also have sugar mimetics such as cyclobutyl moieties in place of the pentofuranosyl sugar.
Nucleotide analogs can also be modified at the phosphate moiety. Modified phosphate moieties include but are not limited to those that can be modified so that the linkage between two nucleotides contains a phosphorothioate, chiral phosphorothioate, phosphorodithioate, phosphotriester, aminoalkylphosphotriester, methyl and other alkyl phosphonates including 3'-alkylene phosphonate and chiral phosphonates, phosphinates, phosphoramidates including 3 '-amino phosphoramidate and aminoalkylphosphoramidates,
thionophosphoramidates, thionoalkylphosphonates, thionoalkylphosphotriesters, and boranophosphates. It is understood that these phosphate or modified phosphate linkage between two nucleotides can be through a 3'-5' linkage or a 2'-5' linkage, and the linkage can contain inverted polarity such as 3'-5' to 5'-3' or 2'-5' to 5'-2'. Various salts, mixed salts and free acid forms are also included.
It is understood that nucleotide analogs need only contain a single modification, but may also contain multiple modifications within one of the moieties or between different moieties.
Nucleotide substitutes are molecules having similar functional properties to nucleotides, but which do not contain a phosphate moiety, such as peptide nucleic acid (PNA). Nucleotide substitutes are molecules that will recognize nucleic acids in a Watson- Crick or Hoogsteen manner, but which are linked together through a moiety other than a phosphate moiety. Nucleotide substitutes are able to conform to a double helix type structure when interacting with the appropriate target nucleic acid.
Nucleotide substitutes are nucleotides or nucleotide analogs that have had the phosphate moiety and/or sugar moieties replaced. Nucleotide substitutes do not contain a standard phosphorus atom. Substitutes for the phosphate can be for example, short chain alkyl or cycloalkylinternucleoside linkages, mixed heteroatom and alkyl or
cycloalkylinternucleoside linkages, or one or more short chain heteroatomic or heterocyclic internucleoside linkages. These include those having morpholino linkages (formed in part from the sugar portion of a nucleoside); siloxane backbones; sulfide, sulfoxide and sulfone backbones; formacetyl and thioformacetyl backbones; methylene formacetyl and thioformacetyl backbones; alkene containing backbones; sulfamate backbones;
methyleneimino and methylenehydrazino backbones; sulfonate and sulfonamide backbones; amide backbones; and others having mixed N, O, S and CH2 component parts.
It is also understood in a nucleotide substitute that both the sugar and the phosphate moieties of the nucleotide can be replaced, by for example an amide type linkage
(aminoethylglycine) (PNA).
It is also possible to link other types of molecules (conjugates) to nucleotides or nucleotide analogs. Conjugates can be chemically linked to the nucleotide or nucleotide analogs. Such conjugates include but are not limited to lipid moieties such as a cholesterol moiety, cholic acid, a thioether, e.g., hexyl-S-tritylthiol, a thiocholesterol, an aliphatic chain, e.g., dodecandiol or undecyl residues, a phospholipid, e.g., di-hexadecyl-rac-glycerol or triethylammonium l,2-di-0-hexadecyl-rac-glycero-3-H-phosphonate, a polyamine or a polyethylene glycol chain, or adamantane acetic acid, a palmityl moiety, or an
octadecylamine or hexylamino-carbonyl-oxycholesterol moiety.
A Watson-Crick interaction is at least one interaction with the Watson-Crick face of a nucleotide, nucleotide analog, or nucleotide substitute. The Watson-Crick face of a nucleotide, nucleotide analog, or nucleotide substitute includes the C2, Nl, and C6 positions of a purine based nucleotide, nucleotide analog, or nucleotide substitute and the C2, N3, C4 positions of a pyrimidine based nucleotide, nucleotide analog, or nucleotide substitute.
A Hoogsteen interaction is the interaction that takes place on the Hoogsteen face of a nucleotide or nucleotide analog, which is exposed in the major groove of duplex DNA. The Hoogsteen face includes the N7 position and reactive groups (NH2 or O) at the C6 position of purine nucleotides.
Hybridization/Selective Hybridization
The term hybridization typically means a sequence driven interaction between at least two nucleic acid molecules, such as a primer or a probe and a gene. Sequence driven interaction means an interaction that occurs between two nucleotides or nucleotide analogs or nucleotide derivatives in a nucleotide specific manner. For example, G interacting with C or A interacting with T are sequence driven interactions. Typically sequence driven interactions occur on the Watson-Crick face or Hoogsteen face of the nucleotide. The hybridization of two nucleic acids is affected by a number of conditions and parameters known to those of skill in the art. For example, the salt concentrations, pH, and temperature of the reaction all affect whether two nucleic acid molecules will hybridize.
Parameters for selective hybridization between two nucleic acid molecules are well known to those of skill in the art. For example, in some embodiments selective
hybridization conditions can be defined as stringent hybridization conditions. For example, stringency of hybridization is controlled by both temperature and salt concentration of either or both of the hybridization and washing steps. For example, the conditions of
hybridization to achieve selective hybridization may involve hybridization in high ionic strength solution (6X SSC or 6X SSPE) at a temperature that is about 12-25°C below the Tm (the melting temperature at which half of the molecules dissociate from their hybridization partners) followed by washing at a combination of temperature and salt concentration chosen so that the washing temperature is about 5°C to 20°C below the Tm. The temperature and salt conditions are readily determined empirically in preliminary experiments in which samples of reference DNA immobilized on filters are hybridized to a labeled nucleic acid of interest and then washed under conditions of different stringencies. Hybridization temperatures are typically higher for DNA-RNA and RNA-RNA
hybridizations. The conditions can be used as described above to achieve stringency, or as is known in the art. A preferable stringent hybridization condition for a DNA:DNA hybridization can be at about 68°C (in aqueous solution) in 6X SSC or 6X SSPE followed by washing at 68°C. Stringency of hybridization and washing, if desired, can be reduced accordingly as the degree of complementarity desired is decreased, and further, depending upon the G-C or A-T richness of any area wherein variability is searched for. Likewise, stringency of hybridization and washing, if desired, can be increased accordingly as homology desired is increased, and further, depending upon the G-C or A-T richness of any area wherein high homology is desired, all as known in the art.
Another way to define selective hybridization is by looking at the amount
(percentage) of one of the nucleic acids bound to the other nucleic acid. For example, in some embodiments selective hybridization conditions would be when at least about, 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100 percent of the limiting nucleic acid is bound to the non-limiting
nucleic acid. Typically, the non-limiting primer is in for example, 10 or 100 or 1000 fold excess. This type of assay can be performed at under conditions where both the limiting and non-limiting primer are for example, 10 fold or 100 fold or 1000 fold below their ka, or where only one of the nucleic acid molecules is 10 fold or 100 fold or 1000 fold or where one or both nucleic acid molecules are above their ka.
Another way to define selective hybridization is by looking at the percentage of primer that gets enzymatically manipulated under conditions where hybridization is required to promote the desired enzymatic manipulation. For example, in some embodiments selective hybridization conditions would be when at least about, 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100 percent of the primer is enzymatically manipulated under conditions which promote the enzymatic manipulation, for example if the enzymatic manipulation is DNA extension, then selective hybridization conditions would be when at least about 60, 65, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100 percent of the primer molecules are extended. Conditions also include those suggested by the manufacturer or indicated in the art as being appropriate for the enzyme performing the manipulation.
Just as with homology, it is understood that there are a variety of methods herein disclosed for determining the level of hybridization between two nucleic acid molecules. It is understood that these methods and conditions may provide different percentages of hybridization between two nucleic acid molecules, but unless otherwise indicated meeting the parameters of any of the methods would be sufficient. For example if 80%
hybridization was required and as long as hybridization occurs within the required parameters in any one of these methods it is considered disclosed herein.
It is understood that those of skill in the art understand that if a composition or method meets any one of these criteria for determining hybridization either collectively or singly it is a composition or method that is disclosed herein.
Kits
Disclosed herein are kits that are drawn to reagents that can be used in practicing the methods disclosed herein. In particular, he kits can include any reagent or combination of reagents discussed herein or that would be understood to be required or beneficial in the practice of the disclosed methods. For example, the kits could include one or more primers from Tables 7-14 disclosed herein to perform the extension, replication and amplification reactions discussed in certain embodiments of the methods, as well as the buffers and enzymes required to use the primers as intended. The kit can also include other necessary reagents to perform any of the next generation sequencing techniques disclosed herein. In another aspect, the disclosed kits can include one or more of the probes listed in Table 15 in addition to or instead of one or more primers from Table 7-14.
It is understood and herein contemplated that the disclosed kits can comprise at least one primer set to detect the presence of nucleic acid variation in each οΐΚΙΤ, BRAF, KRAS, ALK, and EGFR. For example, the kits can comprise at least one primer or primer set for sequencing at least one of each of the KIT, BRAF, KRAS, ALK, and EGFR exons of Tables 1. In one aspect, the kits can comprise at least one primer or primer set from each of Tables 7-14. Alternatively, the kit can comprise a primer or primer set that will detect one or more of the specific mutations listed in Tables 2-6. Therefore, in one aspect disclosed herein are kits for performing a NGS sequencing reaction on a tissue sample to detect the presence of a mutation conferring kinase inhibitor resistance comprising at least one or more primer or primer set from each of Table 7-14. In another aspect, disclosed herein are kits for performing a NGS sequencing reaction on a tissue sample to detect the presence of a mutation conferring kinase inhibitor resistance comprising at least one or more primer or primer set capable of specifically hybridizing an amplifying any of the mutant sequences of KIT, BRAF, KRAS, ALK, and EGFR present in Tables 2-6.
Additionally, it is understood that the disclosed kits can include such other reagents and material for performing the disclosed methods such as enzymes (e.g., polymerases), buffers, sterile water, and/or reaction tubes. Additionally the kits can also include modified nucleotides, nuclease-resistant nucleotides, and or labeled nucleotides. Additionally, the
disclosed kits can include instructions for performing the methods disclosed herein and software for enable the calculation of the presence of a kinase inhibitor mutation (i.e., a mutation in KIT, BRAF, KRAS, EGFR, and/or ALK).
The compositions disclosed herein and the compositions necessary to perform the disclosed methods can be made using any method known to those of skill in the art for that particular reagent or compound unless otherwise specifically noted.
Nucleic Acid Synthesis
The disclosed nucleic acids, such as, the oligonucleotides to be used as primers can be made using standard chemical synthesis methods or can be produced using enzymatic methods or any other known method. Such methods can range from standard enzymatic digestion followed by nucleotide fragment isolation to purely synthetic methods, for example, by the cyanoethylphosphoramidite method using a Milligen or Beckman System lPlus DNA synthesizer (for example, Model 8700 automated synthesizer of Milligen- Biosearch, Burlington, MA or ABI Model 380B).
Examples
The following examples are put forth so as to provide those of ordinary skill in the art with a complete disclosure and description of how the compounds, compositions, articles, devices and/or methods claimed herein are made and evaluated, and are intended to be purely exemplary and are not intended to limit the disclosure. Efforts have been made to ensure accuracy with respect to numbers (e.g., amounts, temperature, etc.), but some errors and deviations should be accounted for. Unless indicated otherwise, parts are parts by weight, temperature is in °C or is at ambient temperature, and pressure is at or near atmospheric.
Example 1: ALK Inhibitor Resistance
Using an in vitro assay known to predict clinically relevant kinase inhibitor- resistance mutations resistance selection studies were performed with XALKORI® and identified a large number of ALK kinase domain point mutations that confer high-level resistance to the Pfizer inhibitor (Figure 1). In response to the issue of resistance, a number
of pharma and biotech companies currently have 2n -generation ALK small-molecule inhibitors in development.
The need for more comprehensive oncogene profiling in patients with ALK inhibitor resistance was observed in an ALK positive crizotinib resistant cohort of patients that ALK specific kinase mutations accounted for only a third of crizotinib resistance. The larger subset of crizotinib resistant cases indicated that second (co-expression in conjunction with ALK) or separate (complete absence of ALK) oncogenic drivers such as EGFR, BRAF, KRAS or cKIT can relieve the sensitivity to crizotinib and drive oncogenesis. It was also observed in a single case that the complete loss of ALK expression did not correspond to the presence of an identifiable alternate driver indicating the genetic profiling of ALK inhibitor resistance cases should be extended past EGFR, BRAF, KRAS or cKIT expression using more versatile testing platforms. The presence of multiple oncogenes present in a single tumor sample is by no means a new phenomenon as EGFR driven tumors resistant to EGFR tyrosine kinase inhibitors can be driven by secondary MET gene amplification.
Example 2: A Diagnostic Cancer Panel that Employs NGS
Applicants have designed and developed a next generation sequencing panel to amplify and sequence one or more exons within ALK and other oncogenes implicated in driving tumorigenesis in the presence of crizotinib (i.e. ALK, BRAF, EGFR, KIT and K- RAS. See Table 1 for an overarching description of the exons targeted for sequencing in the panel and Tables 2-6 for a more detailed list of each mutation detected by the Insight ALK resistance ZD™ panel. Primer sequences used to amplify each gene segment are depicted in Tables 7-14.
EGFR 20
EGFR 21
EGFR 22
ALK 21
ALK 22
ALK 23
ALK 24
ALK 25
KIT 8
KIT 9
KIT 10
KIT 11
KIT 12
KIT 13
KIT 17
BRAF 10
BRAF 11
BRAF 13
BRAF 14
BRAF 15
Example 3: Targeted Next Generation Sequencing Insight ALK resistance ID™
Polymerase chain reaction is used to create amplicons that span the exonic regions mentioned above. The design described here is agnostic to the NGS platform used to perform the actual sequencing, and thus multiple PCR strategies can match the size of the PCR fragments to the read-length of the sequencing platform being employed. The PCR amplification can be done in a single-tube as a multiple reaction where all targets are
covered at once. In the case of low coverage or ambiguous results, a single-plex PCR can be performed as a confirmatory step to ensure accurate mutation calling. This is also true in the case of highly-degraded samples where the template DNA has fragmented and large- amplicons cannot be extracted from the DNA that remains. See Tables 7-14 for a full list of the primers that have been designed and the general size of fragments each set produces. There are a large number of primers in the list to ensure that there is flexibility to run various multiplex PCR reactions where there is very little sequence overlap in the primers, which can lead to dimerization, and allow melting temperatures of all the oligos in a particular reaction to be matched. The amplification parameters of each PCR reaction consist of 95°C 15-min heat denaturation phase followed by 40 cycles of denaturation at 95°C for 15 sec and 55°C annealing for 30 sec and 72°C extension for 1 min and finally a 72°C final extension step for 5 minutes. At the end of the PCR step a diverse set of fragments that cover the exons of interest can be synthesized. The fragments can then be adapted for sequencing on any commercially available NGS platform. Since there is a very wide range of read-lengths that the different NGS instruments produce, from as low as 35 bases to as high as 1500 and expectations of lOOkb read length in the near future, the Insight ALK resistance ID™ is designed to be able to produce fragments as short as 150 bases to as high as 5kb. This ensures for efficient sequencing where the size of each amplicon can be matched to the output of long-read and middle-read technologies (150-1000 bases) or have large enough fragments (5kb) that can be effectively sheared, either sonically or enzymatically, to be compatible with short-read sequencers (<150 bases).
The ALK resistance ID™ takes advantage of the very high-throughput offered by modern sequencers to cover the regions of interest at very high coverage (depth > 5,000X) and thus enable the detection of rare variants only present in the sample at a frequency of 1% or less. The sequence reads that are generated can be compared to a reference sequence examined for the presence of any of the mutations listed in Tables 2-6.
Table 2. ALK Mutations That Are Covered
Amino Acid Mutation Nucleotide Mutation p.V1471fs*45 c.4409_4422delCCGTGGAAGGGGGA p.Y1584Y c.4752C>T p.T1597T c.4791T>A p.L1062l c.3185A>T p.T1087l c.3260C>T p.D1091N c.3271G>A
P.G1128A c.3383G>C
P.M 1166 c.3497T>G
P.A1168P .3502OG
P.I 1171N c.3512T>A
P.F1174I c.3520T>A
P.F1174L c.3522C>A
P.R1192P c.3575G>C p.F1245C c.3734T>G p.F1245V c.3733T>G p.F1245L c.3735C>G p.F1245l c.3733T>A
P.I 1250T c.3749T>C p.R1275Q c.3824G>A
Table 3. EGFR Mutations That Are Covered
Amino Acid Mutation Nucleotide Mutation p.L747_T751>S c.2240_2251del l2
P.L861Q c.2582T>A p.L747_E749del c.2239_2247del9 p.E746_S752>D c.2238_2255del l8 p.E746_A750del c.2235_2249del l5 p.L858R c.2573T>G p.E746_A750del c.2236_2250del l5 p.R776C c.2326C>T p.H835L c.2504A>T p.G719A c.2156G>C
p.T790M c.2369C>T p.S768l c.2303G>T p.V769L c.2305G>T p.G719S c.2155G>A p.G719C c.2155G>T p.L747_T751del c.2239_2253dell5 p.L747_S752del c.2239_2256dell8 p.S752J759del c.2254_2277del24 p.P753S c.2257C>T p.L858M c.2572C>A p.E746_S752>A c.2237_2254dell8 p.L747_T751del c.2240_2254dell5 p.L747_P753>S c.2240_2257dell8 p.E709V c.2126A>T
P.I715S c.2144T>G p.S720F c.2159C>T
P.L861 c.2582T>G p.V769_D770insASV c.2307_2308ins9 p.H773_V774insH c.2319_2320insCAC p.D770_N771insG c.2310_2311insGGT p.V769_D770insCV c.2307_2308insTGCGTG p.H773_V774insPH c.2319_2320insCCCCAC p.H773_V774insNPH c.2319_2320ins9 p.L747_A750>P c.2239_2248TTAAGAGAAG>C p.L747_T751>P c.2239_2251>C p.E746_S752>V c.2237_2255>T p.E746_S752>l c.2235_2255>AAT p.E746_T751>V c.2237_2252>T
p.L747_P753>Q c.2239_2258>CA p.H773>NPY c.2317_2317C>AACCCCT p.V774_C775insHV c.2322_2322G>CCACGTG p.L747_S752>Q c.2239_2256>CAA p.E746_T751>l c.2229_2252>AATTAAGA p.T751J759>S c.2252_2275>G p.E746_A750> P c.2236_2248>AGAC p.E746_T751>VA c.2237_2253>TTGCT p.L747_T751>Q c.2238_2252>GCA p.L747_T751>Q c.2239_2252>CA p.L747_S752>QH c.2238_2255>GCAACA p.L747_A750>P c.2238_2248>GC p.l744_K745insKIPVAI c.2231_2232insl8 p.D761_E762insEAFQ c.2283_2284insl2 p.A767_S768insTLA c.2302_2303ins9 p.V769_D770insASV c.2308_2309ins9 p.D770>GY c.2308_2309insGTT p.E709H c.2125_2127GAA>CAT p.L858R c.2573_2574TG>GT p.A859T c.2575G>A p.E746_T751>A c.2237_2251dell5 p.Y727C c.2180A>G p.V851l c.2551G>A p.E746_T751del c.2236_2253dell8 p.D770_N771>AGG c.2309_2312ACAA>CTGGTGG p.G857R c.2569G>A p.L858R c.2573.T>G p.E746_A750del c.2235_2249dell5
p.E746_A750>QP c.2236_2248>CAAC
P.G810D c.2429G>A p.E709K c.2125G>A p.D770_N771insN c.2310_2311insAAC p.D770_N771insG c.2310_2311insGGC p.H773L c.2318A>T p.V774M c.2320G>A p.G779F c.2335_2336GG>TT p.A871G c.2612C>G p.E709G c.2126A>G
P.L861Q c.2582T>A p.L730F c.2188C>T p.P733L c.2198C>T p.G735S c.2203G>A p.V742A c.2225T>C p.E746K c.2236G>A p.T751l c.2252C>T p.S752Y c.2255C>A p.H850N c.2548C>A p.D761N c.2281G>A p.S784F c.2351C>T p.L792P c.2375T>C p.L798F c.2392C>T
P.G810S c.2428G>A p.N826S c.2477A>G p.T847l c.2540C>T p.V851A c.2552T>C
P.I853T c.2558T>C
p.A864T c.2590G>A
p.E866K c.2596G>A
p.G873E c.2618G>A
p.E746_P753>LS c.2236_2257>CTCT
p.V819V c.2457G>A
p.Y764Y c.2292C>T
p.L833V c.2497T>G
p.V769M c.2305G>A
p.L838V c.2512C>G
p.E709A c.2126A>C
p.D770_N771insSVD c.2311_2312ins9
p.A839T c.2515G>A
p.H773 c.2318A>G
p.P772P c.2316C>T
p.E746_T751>A c.2235_2251>AG
p.E746_A750>IP c.2235_2248>AATTC p.E746_T751>l c.2235_2252>AAT
p.E746_T751>IP c.2235_2251>AATTC
p.L858R c.2572_2573CT>AG
p.N771_P772>SVDNR c.2312_2315ACCC>GCGTGGACAACCG p.D770_P772>ASVDNR c.2308_2315GACAACCC>CCAGCGTGGATAACCG p.S752J759del c.2253_2276del24
p.E746_A750>QP c.2236_2248>CAAC
p.V769_D770insASV c.2309_2310AC>CCAGCGTGGAT p.M766_A767insAI c.2298_2299insGCCATA
p.G724S c.2170G>A
p.D770N c.2308G>A
p.T783l c.2348C>T
p.G863D c.2588G>A p.V897l c.2689G>A p.K745 c.2234A>G p.P741L c.2222C>T p.E734K c.2200G>A p.E746del c.2234_2236delAGG p.E746_T751>VP c.2237_2251>TTC p.Q787R c.2360A>G p.V834L c.2500G>T p.A755A c.2265C>T p.G719D c.2156G>A p.E746_S752>V c.2237_2256>TC p.E746_P753>VS c.2237_2257>TCT p.E746_A750>DP c.2238_2249>TCC p.V769_D770insGSV c.2308_2309ins9 p.V769_D770insGVV c.2308_2309ins9 p.N771>GF c.2311_2312AA>GGGTT p.V774_C775insHV c.2321_2322insCCACGT p.G719C c.2154_2155GG>TT p.L747_R748>FP c.2241_2244AAGA>CCCG p.E872 c.2614G>T p.G873G c.2619A>T p.P753P c.2259G>A p.G719fs*29 c.2156delG p.L747_K754>ST c.2240_2261>CGAC p.S768_V769insVAS c.2303_2304ins9 p.V769_D770insDNV c.2307_2308ins9 p.D770_N771insAPW c.2310_2311ins9
p.1744V c.2230A>G p.S784P c.2350T>C p. 832L c.2495G>T p.V802F c.2404G>T p.E746_E749del c.2235_2246del l2 p.T854A c.2560A>G p.E884K c.2650G>A p.F712S c.2135T>C
P.I744M c.2232C>G p.V765M c.2293G>A p.R836C c.2506C>T p.A871T c.2611G>A p.D855G c.2564A>G p.E868G c.2603A>G p.L798H c.2393T>A
P.K806E c.2416A>G p.L814P c.2441T>C p.E746_A750>VP c.2237_2250>TCCCT p.V769_D770insMASVD c.2307_2308insl5 p.F723S c.2168T>C p.T785N c.2354C>A p.V845M c.2533G>A p.M766T c.2297T>C p.S752P c.2254T>C p.T725T c.2175G>A p.D855N c.2563G>A p.L858Q c.2573T>A p.H870R c.2609A>G
p.F712L c.2134T>C ρ.Ι821Τ c.2462T>C p.V834A c.2501T>C p.L718P c.2153T>C p.D770_N771insNPH c.2310_231 linsAACCCCCAC p.D770_N771insGL c.2310_2311insGGGTTA p.D770_N771insSVD c.2311_2312insGCGTGGACA p.P772_H773insTHP c.2315_2316insGACACACCC p.S720T c.2158T>A p.E746V c.2237_2238AA>TT p.E746_P753>VQ c.2237_2258>TTCA p.E709_T710>D c.2127_2129delAAC p.E746_T751>IP c.2236_2253>ATTCCT p.L747_T751>Q c.2239_2253>CAA p.H773_V774insGNPH c.2320_2321insl2
P.I732T c.2195T>C p.N756Y c.2266A>T p.L844P c.2531T>C
P.I740T c.2219T>C p.E746_T751>VP c.2237_2253>TTCCT p.W731L c.2192G>T p.E734Q c.2200G>C p.T785A c.2353A>G p.C797Y c.2390G>A p. 831H c.2492G>A p.N771>GY c.2311_2311A>GGTT p.P733S c.2197C>T p.R748l c.2243G>T
p.E709_T710>A c.2126_2128delAAA p.E746_S752>V c.2235_2255>GGT p.l744_A750>VK c.2230_2249>GTCAA p.L747_K754>N c.2239_2264>GCCAA p.l740_P741insPVAIKI c.2219_2220insl8 p. 836 c.2508C>T p.V843l c.2527G>A p.K754R c.2261A>G p.A840T c.2518G>A p.K754E c.2260A>G p.A859D c.2576C>A
P.Y801C c.2402A>G
P.I744T c.2231T>C p.T854l c.2561C>T p.G863S c.2587G>A p.H850R c.2549A>G p.K754A c.2260_2261AA>GC p.D807N c.2419G>A p.S720P c.2158T>C p.K757M c.2270A>T p.L862Q c.2585T>A ρ.Τ751_Ι759>Ν c.2252_2276>A p.P772R c.2315C>G p.A839V c.2516C>T p.K716R c.2147A>G p.H773_V774insQ c.2319_2320insCAG p.E711V c.2132_2133AA>TT p.T710A c.2128A>G
p.K714N c.2142G>C p.V717A c.2150T>C p.G729E c.2186G>A p.l744_E749>LK c.2230_2247>CTTAAGAGA p.E746_T751>L c.2236_2253>CTA p.E746_S752>l c.2236_2255>AT p.E746_S752del c.2236_2256del21 p.E746_S752>l c.2236_2256>ATC p.E746_P753>IS c.2236_2259>ATCTCG p.E746_T751>V c.2237_2253>TA p.E746_T751>V c.2237_2253>TC p.L747_A750>P c.2239_2250>CCA p.L747_S752>QH c.2239_2256>CAACAT p.L747_P753>S c.2239_2257>T p.R748K c.2243G>A p.E749G c.2246A>G p.T751J759>S c.2251_2277>TCC p.P772_H773insHV c.2316_2317insCACGTG p.G779D c.2336G>A p.V802A c.2405T>C p.L833W c.2498T>G p.D837G c.2510A>G p.L844V c.2530C>G p.T751J759del c.2252_2275del24 p.V765G c.2294T>G p.G796D c.2387G>A p.R836H c.2507G>A p.K757R c.2270A>G
p.E872K c.2614G>A p.L858L c.2574G>A
P.I780S c.2339T>G ρ.Τ785Ρ c.2353A>C p.Y801fs* l c.2402_2403insG p.L858 c.2573_2574TG>GA p.N771_P772insRH c.2311_2312insACCGGC p.H850Y c.2548C>T p.E868K c.2602G>A
P.I780T c.2339T>C p.E866D c.2598G>T p.L833F c.2499G>T p.A864V c.2591C>T p.K745_A750del c.2232_2249del l8 p.P794H c.2381C>A p.E804K c.2410G>A p.G857E c.2570G>A
p.D479fs*2 .1434_1462del29
p.S480fs*47 c.l439delC
p.N486D c.l456A>G
p.V489l c.l465G>A
p.V489A c.l466T>C
p.E490G c.l469A>G
p.E490_F504>DHIVVSLTF c.l470_1512>CCACATCGTTGTAAGCCTTACATTC p.N495l c.l484A>T
p.N495l c.l484A>T
p.D496V c.l487A>T
p.V50M c.l48G>A
p.V497V c.l491G>A
p.G498D c.l493G>A
p.K499K c.l497G>A
p.A502_Y503insSA c.l504_1505insCTTCTG p.A502_Y503insSA c.l505_1506insTTCTGC p.Y503_F504insSA c.l507_1508insCTGCCT p.A502_Y503insFA c.l507_1508insTTGCCT p.Y503_F504insAY c.l509_1510insGCCTAT
p.F504L c.l510T>C
p.N505H c.l513A>C
p.F506L c.l516T>C
p.F506_A507insAYFNF .1518_1519insl5
p.F508_K509insNFAF .1524_1525insl2
p.K509l c.l526A>T
p.G510del c.l528_1530delGGT p.N512D c.l534A>G
p.P551_V555>L .1652_1663dell2 p.P551_V559del>L .1652_1678del27 p.P551L c.l652C>T p.M552_Y553del c.l653_1658delCATGTA p.M552_Q556> c.l653_1667>TCT p.M552_W557del .1653_1670dell8 p.M552_Y553del c.l654_1659delATGTAT p.M552_E554del .1654_1662del9 p.M552_V555del .1654_1665dell2 p.M552_Q556del .1654_1668dell5 p.M552_W557del .1654_1671dell8 p.M552_K558del .1654_1674del21 p.M552_D572del .1654_1716del63 p.M552L c.l654A>C p.M552L c.l654A>C p.M552_Y553>N c.l655_1657delTGT p.M552_E554>K c.l655_1660delTGTATG p.M552_V555>l .1655_1663del9 p.M552_Q556>K .1655_1666dell2 p.M552_W557> .1655_1669dell5 p.M552_W557del .1655_1672dell8 p.M552_K558>T c.l655_1674>CN p.M552_E561>K .1655_1681del27 p.M552_T574>TESA c.l655_1720>CAGAATCAG p.M552K c.l655T>A p.M552T c.l655T>C p.Y553_W557del .1656_1670dell5 p.Y553_K558> .1656_1673dell8
p.Y553V c.l657_1658TA>GT p.Y553_Q556del C.1657_1668dell2 p.Y553_W557del C.1657_1671dell5 p.Y553_K558del C.1657_1674dell8 p.Y553_V559>E c.l657_1677>GAA p.Y553_V559del C.1657_1677del21 p.Y553N c.l657T>A p.Y553_T574>S C.1658_1720del63 p.E554_K558del C.1660_1674dell5 p.E554_E562del C.1660_1686del27 p.E554_N564del C.1660_1692del33 p.E554J571del C.1660_1713del54 p.E554_D572del C.1660_1716del57 p.E554K c.l660G>A p.E554K c.l660G>A p.E554_K558del C.1661_1675dell5 p.E554G c.l661A>G p.V555_E562del C.1662_1685del24 p.E554D c.l662A>T p.V555_Q556del c.l663_1668delGTACAG p.V555_K558del C.1663_1674dell2 p.V555_V559del C.1663_1677dell5 p.V555_V560del C.1663_1680dell8 p.V555J563del C.1663_1689del27 p.V555_G565del C.1663_1695del33 p.V555_Y570del C.1663_1710del48 p.V555J571del C.1663_1713del51 p.V555_P573del C.1663_1719del57
p.V555l c.l663G>A
p.V555_N566>D .1664_1696del33 p.Q556_V559del .1665_1676dell2 p.V555_V560>V .1665_1679dell5 p.Q556_N566>SNNLQLY c.l665_1696>TTCCAACAACCTTCCACTGT p.Q556_D572del c.l665_1716>T p.Q556_W557del c.l666_1671delCAGTGG p.Q556_V559del .1666_1677dell2 p.Q556_V560>F c.l666_1678>T p.Q556_V560>TTF c.l666_1680>ACAACCTTC p.Q556_V560del .1666_1680dell5 p.Q556_E561>HH c.l666_1683>CATCAT p.Q556_E561del .1666_1683dell8 p.Q556_D572>PS c.l666_1716>CCATCC p.Q556_P573del .1666_1719del54 p.Q556_T574del .1666_1722del57 p.Q556_L576del .1666_1728del63 p.Q556_W557> c.l667_1669delAGT p.W557_K558del c.l667_1672delAGTGGA p.Q556_K558>R c.l667_1673AGTGGAA>G p.W557_E561del .1667_1681dell5
p.Q556R c.l667A>G
p.W557_K558del c.l668_1673delGTGGAA p.Q556_K558>HPCR c.l668_1673GTGGAA>CCCCTGCAG p.Q556_K558>H c.l668_1674GTGGAAG>Y p.Q556_V559>H .1668_1676del9 p.Q556_V559>HT c.l668_1677GTGGAAGGTT>TACT p.Q556_V560>HNLQLY c.l668_1679>CAACCTTCCACTGTA
p.Q556_V560>H .1668_1679dell2 p.W557J571del .1668_1712del45 p.Q556_D572>H .1668_1715del48 p.W557_Q575del .1668_1724del57 p.W557del c.l669_1671delTGG p.W557_K558>E c.l669_1672TGGA>G p.W557_K558del c.l669_1674delTGGAAG p.W557_K558>S c.l669_1674TGGAAG>C p.W557_V559>l c.l669_1675TGGAAGG>A p.W557_V559del .1669_1677del9 p.W557_V560del .1669_1680dell2 p.W557_E561del .1669_1683dell5 p.W557_E562del .1669_1686dell8 p.W557_Q575del .1669_1725del57 p.W557 c.l669T>A p.W557R c.l669T>C p.W557G c.l669T>G p.W557_K558>SS c.l670_1673GGAA>CTTC p.W557_K558>FP c.l670_1674GGAAG>TTCCT p.W557_V559>F c.l670_1675delGGAAGG p.W557_V560>F .1670_1678del9 p.W557_P573>S .1670_1717del48 p.W557S c.l670G>C p.W557_K558>CT c.l671_1673GAA>CAC p.W557_K558>CP c.l671_1673GAA>TCC p.W557_K558>C c.l671_1674GAAG>C p.W557_V559>C c.l671_1676delGAAGGT p.W557_V560>C .1671_1679del9
p.W557 c.l671G>A p.W557C c.l671G>T p.K558_V559>SS c.l672_1676AAGGT>TCTTC p.K558_V559del c.l672_1677delAAGGTT p.K558_V560del .1672_1680del9 p.K558_E562del .1672_1686dell5 p.K558_N564del .1672_1692del21 p.K558_G565del .1672_1695del24 p.K558_D572del .1672_1716del45 p.K558_Q575del .1672_1725del54 p.K558E c.l672A>G p.K558* c.l672A>T p.K558>NP c.l673_1674insTCC p.K558_V560>l c.l673_1678delAGGTTG p.K558_V560>M c.1673_1680AGGTTGTT>TG p.K558_E562del .1673_1687dell5 p.K558_G565> .1673_1693del21 p.K558R c.l673A>G p.K558>NP c.l674_1674G>TCCT p.K558_V559>N c.l674_1676delGGT p.K558_V560>N c.l674_1679delGGTTGT p.K558_Y570>N .1674_1709del36 p.K558_L576>NV c.l674_1726>CG p.K558K c.l674G>A p.K558N c.l674G>C p.K558N c.l674G>Y p.V559del c.l675_1677delGTT p.V559K c.l675_1677GTT>AAG
p.V559_V560del c.l675_1680delGTTGTT p.V559_E561del C.1675_1683del9 p.V559_G565del C.1675_1695del21 p.V559J571del C.1675_1713del39 p.V559_L576del C.1675_1728del54 p.V559l c.l675G>A p.V559_E561del C.1676_1684del9 p.V559_E562del C.1676_1687dell2 p.V559_P573>A C.1676_1717del42 p.V559D c.l676T>A p.V559A c.l676T>C p.V559G c.l676T>G p.V560del c.l678_1680delGTT p.V560_L576del C.1678_1728del51 p.V560E c.l679_1680TT>AG p.V560E c.l679_1680TT>A p.V560del c.l679_1681delTTG p.V560J571del C.1679_1714del36 p.V560D c.l679T>A p.V560A c.l679T>C p.V560G c.l679T>G p.E561del c.l680_1682delTGA p.V560V c.l680T>G p.E561del c.l681_1683delGAG p.E561_P577del C.1681_1731del51 p.E561K c.l681G>A p.E561G c.l682A>G p.E561E c.l683G>A
p.E562_P573del .1684_1719del36 p.E562K c.l684G>A p.E562V c.l685A>T p.E562_V569>D .1686_1706del21 p.l563_D572del .1687_1716del30 p.l563_L576del .1687_1728del42
P.I563V c.l687A>G p.N564_T574del .1690_1722del33 p.N564_L576del .1690_1728del39 p.N564_P577del .1690_1731del42 p.N564_Y578del .1690_1734del45 p.N564H c.l690A>C p.N564_P573>TS c.l691_1717>CCT p.N564_P573>T .1691_1717del27 p.N564S c.l691A>G p.N564K c.l692T>G p.G565 c.l693G>A p.G565E c.l694G>A p.G565V c.l694G>T p.N566D c.l696A>G p.N566S c.l697A>G p.N567_L576>E c.l698_1728>CGAA p.N566N c.l698C>T p.N567_P573del .1699_1719del21 p.N567H c.l699A>C p.N567K c.l701T>A p.Y568_T574del .1702_1722del21 p.Y568D c.l702T>G
p.T574_Q575insl2 .1721_1722ins36 p.T574l c.l721C>T p.Q575del c.l723_1725delCAA p.Q575_P577>T c.l723_1731CAACTTCCT>ACA p.L576del c.l726_1728delCTT p.L576F c.l726C>T p.L576del c.l727_1729delTTC p.L576P c.l727T>C p.L576_P577insQL c.l728_1729insCAACTT p.P577_Y578del c.l729_1734delCCTTAT p.P577S c.l729C>T p.P577_D579del .1730_1738del9 p.P577H c.l730C>A p.P577L c.l730C>T p.D579del c.l735_1737delGAT p.D579_H580insPTQLPYD .1737_1738ins21 p.D579_H580insSYD .1737_1738ins9 p.H580del c.l737_1739delTCA p.H580Y c.l738C>T p.H580_K581insHPYD .1739_1740insl2 p.H580_K581insPYDH .1740_1741insl2 p.H580_K581insPTQLPYDH .1740_1741ins24 p.H580_K581inslDPTQLPYDH .1740_1741ins30 p.H580_K581insYDH .1740_1741ins9 p.K581 c.l742A>G p.W582* c.l745G>A p.W582* c.l746G>A p.E583_F584insPYDHKWE .1748_1749ins21
p.E635G c.l904A>G p.A636V c.l907C>T p.L637F c.l909C>T p.S639P c.l915T>C p.K642Q c.l924A>C p.K642E c.l924A>G p.V643A c.l928T>C p.S645N c.l934G>A p.L647F c.l939C>T p.L647P c.l940T>C p.G648S c.l942G>A p.N649_H650insN c.l947_1948insAAT
P.I653T c.l958T>C p.V654A c.l961T>C p.N655K c.l965T>G p.G663V c.l988G>T p.G664 c.l990G>A p.T670E c.2008_2009AC>GA p.T670l c.2009C>T p.L682fs*l c.2045delT p.S692L c.2075C>T p.E695K c.2083G>A p.H697Y c.2089C>T p.H697fs*28 c.2089delC p.R815_D816insVI c.2445_2446insGTCATA
P.D816I c.2446_2447GA>AT
P.D816F c.2446_2447GA>TT
P.D816N c.2446G>A
P.D816H c.2446G>C
P.D816Y c.2446G>T p.D816>GP c.2447_2448AC>GGCCA p.D816>VVA c.2447_2448AC>TCGTTGCA
P.D816A c.2447A>C
P.D816G c.2447A>G
P.D816V c.2447A>T
P.D816E c.2448C>G
P.D816E c.2448C>G
P.I817V c.2449A>G
P.I817T c.2450T>C
P.K818 c.2453A>G
P.K818K c.2454G>A p.N819Y c.2455A>T p.D820N c.2458G>A p.D820H c.2458G>C p.D820H c.2458G>C p.D820Y c.2458G>T p.D820Y c.2458G>T p.D820A c.2459A>C p.D820G c.2459A>G p.D820V c.2459A>T p.D820E c.2460T>A p.D820E c.2460T>G p.N822H c.2464A>C p.N822Y c.2464A>T p.N822Y c.2464A>T p.N822S c.2465A>G
p.N822K c.2466T>A p.N822N c.2466T>C p.N822K c.2466T>G p.N822K c.2466T>R p.Y823N c.2467T>A p.Y823D c.2467T>G p.Y823C c.2468A>G p.V825l c.2473G>A p.V825A c.2474T>C p.A829P c.2485G>C p.A829V c.2486C>T p. 830* c.2488C>T p.R830* c.2488C>T p.L831P c.2492T>C p.V833L c.2497G>C p.V833V c.2499G>T p.E839K c.2515G>A p.C844Y c.2531G>A p.Y846H c.2536T>C p.F848L c.2542T>C p.E849* c.2545G>T p.W853* c.2558G>A p.S854P c.2560T>C p.L859P c.2576T>C p.L859L c.2577T>G
P.E861E c.2583G>A p.L862L c.2586G>C
p.Q61P c.l82A>C p.Q61 c.l82A>G p.Q61L c.l82A>T p.Q61H c.l83A>C p.Q61H c.l83A>T p.D69fs*4 c.205delG p.G12fs*3 c.35delG p.G13V c.38_39GC>TT p.V14l c.40G>A p.Q61K c.l80_181TC>CA
P.T310I C.9290T
P.S323S c.969G>A p.I326V c.976A>G p.I326T c.977T>C p.F357S c.l070T>C
P.G358G C.1074G>C
P.S364L C.1091OT p.S365L c.l094C>T p.P367R cllOOOG p.S394* C.11810G
P.T401I C.1202OT p.P403fs*8 c.l208delC p.A404fs*9 c.l208_1209insC
P.G421V c.l262G>T
P.G421G c.l263A>G p.K439Q c.l315A>C p.K439T c.l316A>C p.T440P c.l318A>C p.T440A c.l318A>G p.T440T c.l320A>G
P.G442S c.l324G>A p.R444W C.1330OT
p.R444Q c.l331G>A p.R444L c.l331G>T p.R444R c.l332G>A p.R444R c.l332G>T
P.S447S c.l341T>C p.W450* c.l349G>A p.W450L c.l349G>T ρ.Ρ453Τ C.13570A p.P453P c.l359T>C p.G455R c.l363G>A p.G455E c.l364G>A p.Q456* C.13660T p.Q456R c.l367A>G p.Q456Q c.l368G>A ρ.Ι457Τ c.l370T>C p.V459L c.l375G>C p.V459A c.l376T>C p.V459V c.l377G>A p.G460* c.l378G>T
P.G460G c.l380A>G
P.R462G c.l384A>G p.R462K c.l385G>A p.R462I c.l385G>T p.R462R c.l386A>G p.I463V c.l387A>G
P.I463S c.l388T>G p.14631 c.l389T>C
P.G464R C.1390OA
P.G464R c.l390G>C
P.G464E c.l391G>A
P.G464V c.l391G>T
P.S465S c.l395T>C
P.G466R c.l396G>A
P.G466R c.l396G>C
P.G466E c.l397G>A
P.G466A c.l397G>C
P.G466V c.l397G>T
P.G466G c.l398A>G
P.S467P c.l399T>C
P.S467L C.1400OT
p.F468L c.l402T>C
P.F468S c.l403T>C
P.F468C c.l403T>G
p.F468F c.l404T>C
P.G469R C.1405OA
P.G469R C.1405OC
p.G469>? c.l405_1406GG>CT
P.G469S C.1405_1406GG>TC
P.G469L c.l405_1406GG>TT
P.G469S c.l405_1407GGA>AGC
P.G469S c.l405_1407GGA>AGT
P.G469E C.1406OA
P.G469A c.l406G>C
P.G469V c.l406G>T
P.G469G C.1407A>G
P.V471I c.l411G>A p.V471F c.l411G>T p.V471A c.l412T>C
P.Y472S c.l415A>C
P.Y472C c.l415A>G p.K475R c.l424A>G p.K475M c.l424A>T ρ.Κ475Κ c.l425G>A p.D479Y c.l435G>T p.L485L c.l453T>C p.L485S c.l454T>C p.L485_P490>Y c.l454_1469>A p.L485F c.l455G>T p.N486_P490del C.1457_1471dell5 p.V487V c.l461G>A p.L505H c.l514T>A
P.R509* C.15250T p.L514P c.l541T>C p.W531C c.l593G>T p.L537S c.l610T>C p.H539P c.l616A>C p.H542Y c.l624C>T p.K570K c.l710G>A p.H574N C.1720OA p.H574Q C.17220A p.N581S c.l742A>G
P.N581I c.l742A>T p.I582M c.l746A>G p.F583S c.l748T>C p.F583F c.l749T>C p.L584F C.1750OT p.L584P c.l751T>C p.L584L c.l752T>C p.H585H c.l755T>C p.E586K c.l756G>A p.E586E c.l758A>G p.D587N c.l759G>A p.D587A c.l760A>C p.D587G c.l760A>G p.D587E c.1761 OA p.D587E c.l761C>G p.L588P c.l763T>C p.L588R c.l763T>G p.L588L c.l764C>T p.T589A c.l765A>G ρ.Τ589Ι C.17660T ρ.Τ589Τ c.l767A>G p.V590I c.l768G>A p.V590A c.l769T>C p.V590fs*3 c.l769delT p.V590V c.l770A>G p.K591E c.l771A>G p.K591R c.l772A>G
p.I592V c.l774A>G p.I592M c.l776A>G p.15921 c.l776A>T
P.G593S c.l777G>A
P.G593C c.l777G>T p.G593D c.l778G>A p.D594N c.l779_1780TG>GA p.D594N C.1780OA p.D594H c.l780G>C p.D594G c.l781A>G p.D594V c.l781A>T p.D594E c.l782T>A p.D594D c.l782T>C p.D594E c.l782T>G p.F595L c.l783T>C p.F595S c.l784T>C p.F595L c.l785T>A p.F595F c.l785T>C p.F595L c.l785T>G p.G596R c.l786G>C p.G596fs*2 c.l786delG p.G596D c.l787G>A
P.G596G c.l788T>C p.L597V C.17890G p.L597S c.l789_1790CT>TC p.L597Q C.1790T>A p.L597P c.l790T>C
p.L597R C.1790T>G
p.L597L c. l791A>G
p.A598T c. l792G>A
p.A598V C.17930T
p.A598A c. l794T>A
p.A598_T599insV c. l794_1795insGTT p.T599del c. l794_1796delTAC p.T599I C.17960T
p.T599_V600insT c.l796_1797insTAC p.T599_V600>IAL c.l796_1798CAG>TAGCTT p.T599_R603>I C.1796_1809>TC p.T599T c. l797A>B
p.T599T c. l797A>G
p.T599T c. l797A>T
p.T599_V600insTT c.l797_1797A>TACTACG p.T599_V600insTT c.l797_1798ins? p.T599_V600insT c. l797_1798insACA p.T599_V600insDFGLAT C.1798_1799insl8
P.V600R c. l797_1799AGT>GAG
P.V600M c. l798G>A
P.V600L c. l798G>C
P.V600L c. l798G>T
p.V600>YM c.l798_1798G>TACA
P.V600K c.l798_1799GT>AA
P.V600R c. l798_1799GT>AG
P.V600Q c.l798_1799GT>CA
P.V600E c. l799T>A
P.V600A c.l799T>C
P.V600G c.l799T>G
P.V600E c.l799_1800TG>AA
P.V600D c.l799_1800TG>AC
P.V600D c.l799_1800TG>AT p.V600fs*ll c.l799_1800delTG p.V600_K601>E c.l799_1801delTGA p.V600_S602>DT c.1799_1804TGAAAT>ATA p.V600_S605>D c.l799_1814>A
p.V600_S605>DV c.l799_1814>ATGT p.V600_S605>EK c.l799_1815>AAAAG
P.V600V C.1800OA
p.V600? c.(1798-1800)?
P.K601E c.l801A>G
p.K601del c.l801_1803delAAA
P.K601R c.l802A>G
P.K601I c.l802A>T
P.K601N c.l803A>C
P.K601K c.l803A>G
P.K601N c.l803A>T
P.S602S c.l806T>G
p.R603R C.1807OA
p.R603* C.1807OT
p.R603L C.1808OT
p.R603R c.l809A>G
p.W604del c.l808_1810delGAT p.W604R c.l810T>A
p.W604G c.l810T>G
p.W604* C.18HOA
p.W604* c.l812G>A
P.S605G c.l813A>G
p.S605F c.l813_1814AG>TT p.S605N c.l814G>A
p.S605R c.l815T>A
P.G606R C.I8I6OA
P.G606S c.l816_1818GGG>AGT
P.G606E c.l817G>A
P.G606A c.l817G>C
P.G606V c.l817G>T
P.G606G C.I8I8OA
P.S607P c.l819T>C
P.H608R c.l823A>G
P.H608H c.l824T>C
p.Q609R c.l826A>G
P.Q609Q c.l827G>A
P.F610L c.l828T>C
P.F610S c.l829T>C
P.F610F C.1830T>C
P.E611G c.l832A>G
P.E611D c.l833A>C
P.E611E c.l833A>G
p.Q612E c.l834C>G
p.Q612* C.18340T
P.S614P c.l840T>C
P.S614S c.l842T>C p.G615R c.l843G>A
P.S616P c.l846T>C
P.S616F C.18470T
P.I617T C.1850T>C
P.L618L c.l852T>C
P.L618S c.l853T>C
P.L618W c.l853T>G p.W619R c.l855T>C p.Q636E C.1906OG p.Q636* C.1906OT p.Q636R c.l907A>G
P.S637P c.l909T>C p.S637* C.1910OG p.S637L C.1910OT
P.S657S c.l971A>G p.R671Q c.2012G>A p.R682W c.2044C>T p.R682Q c.2045G>A p.K698R c.2093A>G p.A718V C.21530T
P.P731S C.21910T p.P731P C.21930T
111
Primer Sequence
ID 906 Right TTTGCAAAGTCCCTCTCCTTT
891 Left GCAGACTCCTCTAGCCACAAAAG
892 Right TACAACTTTCTCTCCTTAAGCCTCA 907 Left GTTATCACAGCACCGCAGACT
908 Right TACAACTTTCTCTCCTTAAGCCTCA
893 Left GCAGACTCCTCTAGCCACAAAA
894 Right TACAACTTTCTCTCCTTAAGCCTCA 909 Left GCAGACTCCTCTAGCCACAAA
910 Right TACAACTTTCTCTCCTTAAGCCTCA
895 Left AGACTCCTCTAGCCACAAAAGG
896 Right TACAACTTTCTCTCCTTAAGCCTCA 911 Left GCAGTGTAGGGGCTGAATGTTA
912 Right TACAACTTTCTCTCCTTAAGCCTCA
897 Left CAGTGTAGGGGCTGAATGTTATC
898 Right GCATGCATACAACTTTCTCTCCTT 913 Left TAGGGGCTGAATGTTATCACAGC
914 Right TACAACTTTCTCTCCTTAAGCCTCA
899 Left GCAGTGTAGGGGCTGAATGTTATC
900 Right TACAACTTTCTCTCCTTAAGCCTCA 915 Left CAGACTCCTCTAGCCACAAAAGG
916 Right GCATGCATACAACTTTCTCTCCTTA
901 Left GTAGGGGCTGAATGTTATCACAGC
902 Right TACAACTTTCTCTCCTTAAGCCTCA 917 Left GCAGTGTAGGGGCTGAATGTTAT
918 Right ACAACTTTCTCTCCTTAAGCCTCA
903 Left GAGGACAAGCCTTGACATTCAG
904 Right TACAACTTTCTCTCCTTAAGCCTCA 919 Left ATGTTGGCTTACATTAACTCCCATA
920 Right CAAAGTCCCTCTCCTTTGCAT
ALK Exoii24 130-150 bases
Seq. 939 Left AGTGGCCCGCTTCTGTCT
Primer Sequence
ID 940 Right ATGACAGGAAGAGCACAGTCAC
921 Left AGTGGCCCGCTTCTGTCT
922 Right GATGACAGGAAGAGCACAGTCAC Seq.
Primer Sequence
ID
923 Left CGCTTCTGTCTCCCCACAG 941 Left CGCTTCTGTCTCCCCACAG
924 Right GATGACAGGAAGAGCACAGTCAC 942 Right ATGACAGGAAGAGCACAGTCAC
925 Left CGCTTCTGTCTCCCCACA 943 Left CGCTTCTGTCTCCCCACA
926 Right GATGACAGGAAGAGCACAGTCAC 944 Right ATGACAGGAAGAGCACAGTCAC
927 Left AGTGGCCCGCTTCTGTCT 945 Left AGTGGCCCGCTTCTGTCT
928 Right AGGATGACAGGAAGAGCACAGT 946 Right AGGATGACAGGAAGAGCACAGTC
929 Left CGCTTCTGTCTCCCCACAG 947 Left CGCTTCTGTCTCCCCACAG
930 Right AGGATGACAGGAAGAGCACAGT 948 Right AGGATGACAGGAAGAGCACAGTC
931 Left CGCTTCTGTCTCCCCACA 949 Left CGCTTCTGTCTCCCCACA
932 Right AGGATGACAGGAAGAGCACAGT 950 Right AGGATGACAGGAAGAGCACAGTC
933 Left AGTGGCCCGCTTCTGTCT 951 Left AGTGGCCCGCTTCTGTCT
934 Right GATGACAGGAAGAGCACAGTCA 952 Right GGATGACAGGAAGAGCACAGTC
935 Left CGCTTCTGTCTCCCCACAG 953 Left CGCTTCTGTCTCCCCACAG
936 Right GATGACAGGAAGAGCACAGTCA 954 Right GGATGACAGGAAGAGCACAGTC
937 Left CGCTTCTGTCTCCCCACA 955 Left CGCTTCTGTCTCCCCACAG
938 Right GATGACAGGAAGAGCACAGTCA 956 Right GACAGGATGACAGGAAGAGCAC
957 Left CGCTTCTGTCTCCCCACA 959 Left CGCTTCTGTCTCCCCACA
958 Right GGATGACAGGAAGAGCACAGTC 960 Right GACAGGATGACAGGAAGAGCAC Ζ ΓΕχοη24 161-200 bases
Seq.
Primer Sequence
ID J81 Left ATTTCAGATTTCCCTCCTCTCACT
961 Left ATTTCAGATTTCCCTCCTCTCACT J82 Right AGGATGACAGGAAGAGCACAGTC
962 Right GATGACAGGAAGAGCACAGTCAC
Seq. Left ATTTCAGATTTCCCTCCTCTCACT
Primer equence
ID J84 Right GGATGACAGGAAGAGCACAGTC
963 Left ATTTCAGATTTCCCTCCTCTCACT
964 Right AGGATGACAGGAAGAGCACAGT ?85 Left TTTCAGATTTCCCTCCTCTCACT
965 Left ATTTCAGATTTCCCTCCTCTCACT J86 Right GATGACAGGAAGAGCACAGTCA
966 Right GATGACAGGAAGAGCACAGTCA
?87 Left ATTTCAGATTTCCCTCCTCTCAC
967 Left ATTTCAGATTTCCCTCCTCTCAC J88 Right AGGATGACAGGAAGAGCACAGTC
968 Right GATGACAGGAAGAGCACAGTCAC
m Left TTTCAGATTTCCCTCCTCTCACT
969 Left ATTTCAGATTTCCCTCCTCTCAC ?90 Right ATGACAGGAAGAGCACAGTCAC
970 Right AGGATGACAGGAAGAGCACAGT
m Left ATTTCAGATTTCCCTCCTCTCAC
971 Left ATTTCAGATTTCCCTCCTCTCACT m Right GGATGACAGGAAGAGCACAGTC
972 Right ATGACAGGAAGAGCACAGTCAC
m Left ATTTCAGATTTCCCTCCTCTCACT
973 Left ATTTCAGATTTCCCTCCTCTCAC m Right AGGATGACAGGAAGAGCACAG
974 Right GATGACAGGAAGAGCACAGTCA
Left ATTTCCCTCCTCTCACTGACAA
975 Left ATTTCAGATTTCCCTCCTCTCAC m Right GATGACAGGAAGAGCACAGTCAC
976 Right ATGACAGGAAGAGCACAGTCAC
Left ATTTCCCTCCTCTCACTGACAA
977 Left TTTCAGATTTCCCTCCTCTCACT m Right AGGATGACAGGAAGAGCACAGT
978 Right GATGACAGGAAGAGCACAGTCAC
Left CATTTCAGATTTCCCTCCTCTCACT
979 Left TTTCAGATTTCCCTCCTCTCACT 1 000 Right GATGACAGGAAGAGCACAGTCAC
980 Right AGGATGACAGGAAGAGCACAGT
ALK Exon24 201-300 bases
Seq.
Primer Sequence
ID 1011 Left ATTTCAGATTTCCCTCCTCTCACT
1001 Left ATTTCAGATTTCCCTCCTCTCACT 1012 Right AGGGAGACCTAGTATTCTGCTCTGA
1002 Right GAGACCTAGTATTCTGCTCTGAAGG
1013 Left ATTTCAGATTTCCCTCCTCTCACT
1003 Left ATTTCAGATTTCCCTCCTCTCACT 1014 Right TCTGGAGGGAGACCTAGTATTCTG
1004 Right GGAGACCTAGTATTCTGCTCTGAAG
1015 Left ATTTCAGATTTCCCTCCTCTCAC
1005 Left ATTTCAGATTTCCCTCCTCTCACT 1016 Right CTCTGGAGGGAGACCTAGTATTCTG
1006 Right CTCTGGAGGGAGACCTAGTATTCTG Seq.
Primer Sequence
ID
1007 Left ATTTCAGATTTCCCTCCTCTCAC 1017 Left ATTTCAGATTTCCCTCCTCTCACT
1008 Right GAGACCTAGTATTCTGCTCTGAAGG 1018 Right GGGAGACCTAGTATTCTGCTCTGA
1009 Left ATTTCAGATTTCCCTCCTCTCAC 1019 Left ATTTCAGATTTCCCTCCTCTCAC
1010 Right GGAGACCTAGTATTCTGCTCTGAAG 1020 Right AGGGAGACCTAGTATTCTGCTCTGA
1084 Right ACAATAAAACAAAGCTGAATCATCC
103 Left TGCACAATAAATTAAAAGGGAAAGA
1085 Left GTGCACAATAAATTAAAAGGGAAAG 104 Right GAGACCTAGTATTCTGCTCTGAAGG
1086 Right AAACAAAGCTGAATCATCCTACATC
105 Left TGCACAATAAATTAAAAGGGAAAGA
1087 Left TGCACAATAAATTAAAAGGGAAAGA 106 Right GGAGACCTAGTATTCTGCTCTGAAG
1088 Right AAAACAAAGCTGAATCATCCTACAT
Seq. 107 Left TGTGCACAATAAATTAAAAGGGAAA
Primer Sequence
ID 108 Right ACAATAAAACAAAGCTGAATCATCC
1089 Left ATCATATTACCTGGGAAGACTTCAA
1090 Right AAACAAAGCTGAATCATCCTACATC 109 Left TGTTTATAAATTGGGGGTATTCAAA
110 Right GAGACCTAGTATTCTGCTCTGAAGG
1091 Left GTGCACAATAAATTAAAAGGGAAAG
1092 Right ACAATAAAACAAAGCTGAATCATCC 1 1 1 Left TTGTTTATAAATTGGGGGTATTCAA
112 Right GAGACCTAGTATTCTGCTCTGAAGG
1093 Left TGTGCACAATAAATTAAAAGGGAAA
1094 Right AAACAAAGCTGAATCATCCTACATC 1 13 Left TGTTTATAAATTGGGGGTATTCAAA
114 Right GGAGACCTAGTATTCTGCTCTGAAG
1095 Left TGCACAATAAATTAAAAGGGAAAGA
1096 Right TAAAACAAAGCTGAATCATCCTACA 1 15 Left TTGTTTATAAATTGGGGGTATTCAA
116 Right GGAGACCTAGTATTCTGCTCTGAAG
1097 Left TAAATTAAAAGGGAAAGAACACCTG
1098 Right AAACAAAGCTGAATCATCCTACATC 117 Left GTGCACAATAAATTAAAAGGGAAAG
118 Right AAAACAAAGCTGAATCATCCTACAT
1099 Left GCACAATAAATTAAAAGGGAAAGAA
1 100 Right AAACAAAGCTGAATCATCCTACATC 119 Left TAAATTAAAAGGGAAAGAACACCTG
120 Right ACAATAAAACAAAGCTGAATCATCC
1 101 Left TGGGAAGACTTCAAATGTACAAATA
1 102 Right AAACAAAGCTGAATCATCCTACATC
ALK Exoii24 601-800 bases
Seq.
Primer Sequence
ID 135 Left CTTGTTTATAAATTGGGGGTATTCA
1 121 Left TGTTTATAAATTGGGGGTATTCAAA 136 Right AAACAAAGCTGAATCATCCTACATC
1 122 Right AAACAAAGCTGAATCATCCTACATC
137 Left TGCACAATAAATTAAAAGGGAAAGA
1 123 Left TTGTTTATAAATTGGGGGTATTCAA 138 Right GCAAGTGAATCCCTGATAGAATAAG
1 124 Right AAACAAAGCTGAATCATCCTACATC
139 Left CTGGATCTGCTTGAAGAAAATTAGT
1 125 Left TGTTTATAAATTGGGGGTATTCAAA 140 Right AAACAAAGCTGAATCATCCTACATC
1 126 Right ACAATAAAACAAAGCTGAATCATCC
1 127 Left TGCACAATAAATTAAAAGGGAAAGA >eq.
Primer Sequence
1 128 Right AGTTACCATCTCAAAGACAAAGCTG ID
141 Left CAAACTTGTTTATAAATTGGGGGTA
1 129 Left TGTTTATAAATTGGGGGTATTCAAA 142 Right ACAATAAAACAAAGCTGAATCATCC
1 130 Right AGTTACCATCTCAAAGACAAAGCTG
143 Left TTTATAAATTGGGGGTATTCAAATG
1 131 Left TTGTTTATAAATTGGGGGTATTCAA 144 Right AAACAAAGCTGAATCATCCTACATC
1 132 Right AGTTACCATCTCAAAGACAAAGCTG
145 Left TGTTTATAAATTGGGGGTATTCAAA
1 133 Left CAAACTTGTTTATAAATTGGGGGTA 146 Right AAAACAAAGCTGAATCATCCTACAT
1270 Right GAGGGGTGAGGCAGTCTTTACTCA : 275 Left CCTAGGGATAAAATTAGGAAATGC
: 276 Right GAGGGGTGAGGCAGTCTTTACT
1271 Left TTCCTAGGGATAAAATTAGGAAATGC
1272 Right GGGGTGAGGCAGTCTTTACTC : 277 Left TTCCTAGGGATAAAATTAGGAAATG
: 278 Right GGGTGAGGCAGTCTTTACTCA
1273 Left CCTAGGGATAAAATTAGGAAATGC
1274 Right AGGGGTGAGGCAGTCTTTACTC : 279 Left TTCCTAGGGATAAAATTAGGAAATG
280 Right AGGGGTGAGGCAGTCTTTACT
] 595 Left TGTAGCTTAGCAAGGGCTTTAGATA
1589 Left AACTTCAGCTTGGAGATAAAATCCT ] 596 Right GGAACTAGAGGCTAGGAAGAGAAGA
1590 Right GTGCTGAGGACATAAATAGGTCAGT
] 597 Left GGACAGTAATAGCACCTTGTGTCTT
1591 Left TGTAGCTTAGCAAGGGCTTTAGATA ] 598 Right TCAGTGACACAAATGAAGAATTGAT
1592 Right AGTCTCACTTATTCCCCAAAGAGTT
] 599 Left TTAATCATTTCCCCTAATCCTTTTC
1593 Left TGTAGCTTAGCAAGGGCTTTAGATA ] 600 Right TGCATTGCAATATAGAAAACACAGT
1594 Right GGTGTCTGGATCAGTCTCACTTATT
ALK Έχοη24-25 5kb
Seq. 622 Right AGCCTGAAAAGGAACTTAGTGAAAT
Primer Sequence
ID
1601 Left ATCTCCTTTTGAATGAAAGAGACCT
1602 Right TGGTCACTAATTAAGGTTTCCCATA
Seq.
Primer Sequence 623 Left TGCACAATAAATTAAAAGGGAAAGA ID 624 Right TGGTCACTAATTAAGGTTTCCCATA
1603 Left ATCTCCTTTTGAATGAAAGAGACCT
1604 Right AGCCTGAAAAGGAACTTAGTGAAAT 625 Left TGTTTATAAATTGGGGGTATTCAAA
1605 Left ACGTCAGGGATTTAGGAATTAAAAG 626 Right TGGTCACTAATTAAGGTTTCCCATA
1606 Right TGGTCACTAATTAAGGTTTCCCATA
627 Left TTGTTTATAAATTGGGGGTATTCAA
1607 Left ATGTGAATCATACTCCTCCAGGTAA 628 Right TGGTCACTAATTAAGGTTTCCCATA
1608 Right TGGTCACTAATTAAGGTTTCCCATA
629 Left TGAATCATACTCCTCCAGGTAAATC
1609 Left ATCTCCTTTTGAATGAAAGAGACCT 630 Right TGGTCACTAATTAAGGTTTCCCATA
1610 Right GTATCCAAGTTATCCCATGTCTCAG
631 Left AGGTATGTGAATCATACTCCTCCAG
1611 Left ATCTCCTTTTGAATGAAAGAGACCT 632 Right AGCCTGAAAAGGAACTTAGTGAAAT
1612 Right TAGCCTGAAAAGGAACTTAGTGAAA
633 Left ACGTCAGGGATTTAGGAATTAAAAG
1613 Left ACGTCAGGGATTTAGGAATTAAAAG 634 Right TAGCCTGAAAAGGAACTTAGTGAAA
1614 Right AGCCTGAAAAGGAACTTAGTGAAAT
635 Left AAGAGTCACCAGCTTAAACAAACAC
1615 Left ATCTCCTTTTGAATGAAAGAGACCT 636 Right TAGCCTGAAAAGGAACTTAGTGAAA
1616 Right CATAGCCTGAAAAGGAACTTAGTGA
637 Left ATGTGAATCATACTCCTCCAGGTAA
1617 Left AGGTATGTGAATCATACTCCTCCAG 638 Right TAGCCTGAAAAGGAACTTAGTGAAA
1618 Right TGGTCACTAATTAAGGTTTCCCATA
639 Left TGCACAATAAATTAAAAGGGAAAGA
1619 Left AAGAGTCACCAGCTTAAACAAACAC 640 Right AGCCTGAAAAGGAACTTAGTGAAAT
1620 Right AGCCTGAAAAGGAACTTAGTGAAAT
1621 Left ATGTGAATCATACTCCTCCAGGTAA
Table 8. EGFR Capture Primer List for NGS Panel
EGFR Exonl8 100-200 bases
Seq. ] 644 Right TTCTTGACGAGGTCCATGTG
Primer Sequence
ID
1641 Left TGCCAAAGAAGTAGAATGAG Ί 645 Left TGCCAAAGAAGTAGAATGAG
1642 Right AAAGCATCTTCACCCACAGC J 646 Right GTCAGAAATGCAGGAAAGCA
1643 Left TGCCAAAGAAGTAGAATGAG ] 647 Left TGCCAAAGAAGTAGAATGAG
1713 Left TGCCAAAGAAGTAGAATGAG 717 Left GCCAAAGAAGTAGAATGAGA
1714 Right AACCAGCTGGGCAGTCTCT 718 Right CCAGCACTGTGTGTCCAACT
1715 Left TGCCAAAGAAGTAGAATGAG 719 Left GCCAAAGAAGTAGAATGAGA
1716 Right GAAACCCTGGCTGAGGGTAG 720 Right TCCCTCCACTGAGGACAAAG
EGFR Exonl8 400-1000 bases
Seq.
Primer Sequence
ID 739 Left TGCCAAAGAAGTAGAATGAG
1721 Left TGCCAAAGAAGTAGAATGAG 740 Right ACGCCATCGAGAGTAACACC
1722 Right CAGTGTGGAGTGGGGAAGTT
J 741 Left TGCCAAAGAAGTAGAATGAG
1723 Left TGCCAAAGAAGTAGAATGAG J 742 Right AGGAGCATGCCAAAATGAAG
1724 Right ACTCCCCTATGCTGGAGGTT
Ί 743 Left TGCCAAAGAAGTAGAATGAG
1744 Right TGTTGAAGGAAGCCCTTTTG
Seq. 745 Left TGCCAAAGAAGTAGAATGAG
Primer Sequence
ID 746 Right CCAATGGGGTAAGTGGACAG
1725 Left TGCCAAAGAAGTAGAATGAG
1726 Right TGGGAAAGAAAGCAAGGAGA 747 Left TGCCAAAGAAGTAGAATGAG
748 Right TTGCCTTCTTCCTCGATCAT
1727 Left TGCCAAAGAAGTAGAATGAG
1728 Right TCTGGGAAAGAAAGCAAGGA 749 Left TGCCAAAGAAGTAGAATGAG
750 Right CATCGAACAGAAAGGCCACT
1751 Left TGCCAAAGAAGTAGAATGAG
1729 Left TGCCAAAGAAGTAGAATGAG J 752 Right GGTGGCAGGAGAGAGAGCTA
1730 Right ACCAATGGGGTAAGTGGACA
753 Left TGCCAAAGAAGTAGAATGAG
1731 Left TGCCAAAGAAGTAGAATGAG J 754 Right ATGGGACCAATGGGGTAAGT
1732 Right CCTCGATCATGTGACACTGG
Ί 755 Left TGCCAAAGAAGTAGAATGAG
1733 Left TGCCAAAGAAGTAGAATGAG 756 Right TGGAGGTTGTCATCGAACAG
1734 Right AAAATGGCAAACAGGTGCTC
Ί 757 Left TGCCAAAGAAGTAGAATGAG
1735 Left TGCCAAAGAAGTAGAATGAG 758 Right CTGGAGGTTGTCATCGAACA
1736 Right AACTGGCCAGAGCTGATGTT
759 Left TGCCAAAGAAGTAGAATGAG
1737 Left TGCCAAAGAAGTAGAATGAG J 760 Right TATGCTGGAGGTTGTCATCG
1738 Right AAACTGGCCAGAGCTGATGT
EGFR Exonl9 100-200 bases
Seq.
Primer Sequence
ID 767 Left CTTGTTCCTCCACCTCATTCC
1761 Left CTTCCTTGTTCCTCCACCTCAT 768 Right ACCCAGGACTGGCACTCAC
1762 Right ACCCAGGACTGGCACTCAC
Ί 769 Left CCTTGTTCCTCCACCTCATTC
1763 Left CTTCCTTGTTCCTCCACCTCAT 770 Right ACCCAGGACTGGCACTCAC
1764 Right CCCAGGACTGGCACTCAC
J 771 Left TCCTTGTTCCTCCACCTCATT
1765 Left CTTCCTTGTTCCTCCACCTCAT J 772 Right ACCCAGGACTGGCACTCAC
1766 Right ACCCAGGACTGGCACTCA
EGFR Exonl9 400-1000 bases
Seq.
Primer Sequence
ID 861 Left CTCGTTCAGAGAGTATTTCACACAA
1841 Left AATACCAATCCATGAAAAAGCATTA 862 Right AACATGTCACCAACTGGGTATAACT
1842 Right AACATGTCACCAACTGGGTATAACT
J 863 Left TCCAAGATCATTCTACAAGATGTCA
1843 Left CCTATTCCTTTATAACCCCTTTCAA J 864 Right ACTGAACAGCTACCTTTCAACAAAC
1844 Right AACATGTCACCAACTGGGTATAACT
Ί 865 Left CCTATTCCTTTATAACCCCTTTCAA
1845 Left TCCAAGATCATTCTACAAGATGTCA j 866 Right AACTGCACATTCAGAGATTCTTTCT
1846 Right AACATGTCACCAACTGGGTATAACT
Ί 867 Left TCCAAGATCATTCTACAAGATGTCA
1847 Left TTTCAAGCTCGTTCAGAGAGTATTT j 868 Right AACTGCACATTCAGAGATTCTTTCT
1848 Right AACATGTCACCAACTGGGTATAACT
869 Left ACTCTTGGAATGAACAAAATACCAA
1849 Left TTCAGAGAGTATTTCACACAATCCA j 870 Right AACATGTCACCAACTGGGTATAACT
1850 Right AACATGTCACCAACTGGGTATAACT
Seq. 871 Left CCTATTCCTTTATAACCCCTTTCAA
Primer Sequence
ID 872 Right GGGTATAACTGCACATTCAGAGATT
1851 Left GTGTCTCACTTTCCAAGATCATTCT
1852 Right AACATGTCACCAACTGGGTATAACT 873 Left TCCAAGATCATTCTACAAGATGTCA
874 Right GGGTATAACTGCACATTCAGAGATT
1853 Left AGTGTCTCACTTTCCAAGATCATTC
1854 Right AACATGTCACCAACTGGGTATAACT 875 Left AGTGTCTCACTTTCCAAGATCATTC
876 Right ACTGAACAGCTACCTTTCAACAAAC
1855 Left CCATGAAAAAGCATTATTGAAGTCT
1856 Right AACATGTCACCAACTGGGTATAACT 877 Left GTGTCTCACTTTCCAAGATCATTCT
878 Right ACTGAACAGCTACCTTTCAACAAAC
1857 Left TATTCCTTTATAACCCCTTTCAAGC
1858 Right AACATGTCACCAACTGGGTATAACT 879 Left AGTGTCTCACTTTCCAAGATCATTC
880 Right AACTGCACATTCAGAGATTCTTTCT
1859 Left ATGGAAATACTCTTGGAATGAACAA
1860 Right AACATGTCACCAACTGGGTATAACT
EGFR Exon20 100-200 bases
Seq. 891 Left AGGTGACCCTTGTCTCTGTGTT
Primer Sequence
ID 892 Right CCTGTGCCAGGGACCTTAC
1881 Left GTGACCCTTGTCTCTGTGTTCTT
1882 Right CCTGTGCCAGGGACCTTAC 893 Left GACCCTTGTCTCTGTGTTCTTGT
894 Right CCTGTGCCAGGGACCTTA
1883 Left ACCCTTGTCTCTGTGTTCTTGTC
1884 Right CCTGTGCCAGGGACCTTAC 895 Left GTGACCCTTGTCTCTGTGTTCTT
896 Right CCTGTGCCAGGGACCTTA
1885 Left GACCCTTGTCTCTGTGTTCTTGT
1886 Right CCTGTGCCAGGGACCTTAC 897 Left ACCCTTGTCTCTGTGTTCTTGTC
898 Right CCTGTGCCAGGGACCTTA
1887 Left GACCCTTGTCTCTGTGTTCTTGTC
1888 Right CCTGTGCCAGGGACCTTAC 899 Left GACCCTTGTCTCTGTGTTCTTGTC
900 Right CCTGTGCCAGGGACCTTA
1889 Left GTGACCCTTGTCTCTGTGTTCTTGT
1890 Right CCTGTGCCAGGGACCTTAC >eq.
Primer Sequence
ID
1901 Left GTGACCCTTGTCTCTGTGTTCTTG 911 Left CTGAGGTGACCCTTGTCTCTGT
1902 Right CCTGTGCCAGGGACCTTAC 912 Right CCTGTGCCAGGGACCTTAC
1903 Left TGACCCTTGTCTCTGTGTTCTTGT 913 Left AGGTGACCCTTGTCTCTGTGTTCTT
1904 Right CCTGTGCCAGGGACCTTAC 914 Right CCTGTGCCAGGGACCTTAC
1905 Left GAGGTGACCCTTGTCTCTGTGT 915 Left GGTGACCCTTGTCTCTGTGTTCT
1906 Right CCTGTGCCAGGGACCTTAC 916 Right CCTGTGCCAGGGACCTTAC
1907 Left TGACCCTTGTCTCTGTGTTCTTG 917 Left AGGTGACCCTTGTCTCTGTGTTC
1908 Right CCTGTGCCAGGGACCTTAC 918 Right CCTGTGCCAGGGACCTTAC
1909 Left AGGTGACCCTTGTCTCTGTGTTCT 919 Left GAGGTGACCCTTGTCTCTGTGTT
1910 Right CCTGTGCCAGGGACCTTAC 920 Right CCTGTGCCAGGGACCTTAC
EGFR Exon20 200-400 bases
Seq.
Primer Sequence
ID _ 941 Left TACATTTGTCCTTCCAAATGAGC
1921 Left AAGCTCTGTAGAGAAGGCGTACAT 942 Right AAATATACAGCTTGCAAGGACTCTG
1922 Right AAATATACAGCTTGCAAGGACTCTG
Seq. 943 Left CAAGCTCTGTAGAGAAGGCGTACAT
Primer Sequence
ID 944 Right AAATATACAGCTTGCAAGGACTCTG
1923 Left AGCTCTGTAGAGAAGGCGTACATT
1924 Right AAATATACAGCTTGCAAGGACTCTG 945 Left AGCTCTGTAGAGAAGGCGTACATT
1925 Left TCTGTAGAGAAGGCGTACATTTGTC 946 Right GGAAATATACAGCTTGCAAGGACTC
1926 Right AAATATACAGCTTGCAAGGACTCTG
947 Left AAGCTCTGTAGAGAAGGCGTACAT
1927 Left GTAGAGAAGGCGTACATTTGTCCT 948 Right GGAAATATACAGCTTGCAAGGACTC
1928 Right AAATATACAGCTTGCAAGGACTCTG
949 Left GTCAAGCTCTGTAGAGAAGGCGTA
1929 Left AAGCTCTGTAGAGAAGGCGTACATT 950 Right AAATATACAGCTTGCAAGGACTCTG
1930 Right AAATATACAGCTTGCAAGGACTCTG
: 951 Left TCTGTAGAGAAGGCGTACATTTGTC
1931 Left GCTCTGTAGAGAAGGCGTACATTT 952 Right GGAAATATACAGCTTGCAAGGACTC
1932 Right AAATATACAGCTTGCAAGGACTCTG
: 953 Left TGTAGAGAAGGCGTACATTTGTCCT
1933 Left CTCTGTAGAGAAGGCGTACATTTG 954 Right AAATATACAGCTTGCAAGGACTCTG
1934 Right AAATATACAGCTTGCAAGGACTCTG
: 955 Left GTAGAGAAGGCGTACATTTGTCCT
1935 Left CTGTAGAGAAGGCGTACATTTGTC 956 Right GGAAATATACAGCTTGCAAGGACTC
1936 Right AAATATACAGCTTGCAAGGACTCTG
957 Left AAGCTCTGTAGAGAAGGCGTACATT
1937 Left TTCTGTCAAGCTCTGTAGAGAAGG 958 Right GGAAATATACAGCTTGCAAGGACTC
1938 Right AAATATACAGCTTGCAAGGACTCTG
959 Left AGCTCTGTAGAGAAGGCGTACATT
1939 Left AAGCTCTGTAGAGAAGGCGTACA 960 Right ATGGAAATATACAGCTTGCAAGGAC
1940 Right AAATATACAGCTTGCAAGGACTCTG
EGFR Exon20 400-1000 bases
Seq.
Primer Sequence
ID j 963 Left GTTTCTACCAACTTCTGTCAAGCTC
1961 Left TTTCTACCAACTTCTGTCAAGCTCT j 964 Right ATCTAGAAGAAGCAAACGAAGATGA
1962 Right ATCTAGAAGAAGCAAACGAAGATGA
1965 Left GTTTCTACCAACTTCTGTCAAGCTC 983 Left AATCTCTGAATGTGCAGTTATACCC
1966 Right GATCTAGAAGAAGCAAACGAAGATG 984 Right AAATATACAGCTTGCAAGGACTCTG
1967 Left GTTTCTACCAACTTCTGTCAAGCTC 985 Left TTTCTACCAACTTCTGTCAAGCTCT
1968 Right CTATGACAGAGAGAGAAGGAAGACC 986 Right GTTATAAAGTCCGTGTGGATCATTT
1969 Left CTGTGTTTCTACCAACTTCTGTCAA 987 Left CTGTGTTTCTACCAACTTCTGTCAA
1970 Right GATCTAGAAGAAGCAAACGAAGATG 988 Right AAATATACAGCTTGCAAGGACTCTG
1971 Left TGTGTTTCTACCAACTTCTGTCAAG 989 Left TTTCTACCAACTTCTGTCAAGCTCT
1972 Right ATCTAGAAGAAGCAAACGAAGATGA 990 Right TTATAAAGTCCGTGTGGATCATTTC
1973 Left TGTGTTTCTACCAACTTCTGTCAAG 991 Left GAAATTGTGTTTGTTGAAAGGTAGC
1974 Right GATCTAGAAGAAGCAAACGAAGATG 992 Right AAATATACAGCTTGCAAGGACTCTG
1975 Left CTGTGTTTCTACCAACTTCTGTCAA 993 Left TTTCTACCAACTTCTGTCAAGCTCT
1976 Right ATCTAGAAGAAGCAAACGAAGATGA 994 Right CTGTTATAAAGTCCGTGTGGATCAT
Seq.
Primer Sequence
ID 995 Left GTTTCTACCAACTTCTGTCAAGCTC
1977 Left AGAAAGAATCTCTGAATGTGCAGTT J 996 Right GTTATAAAGTCCGTGTGGATCATTT
1978 Right AAATATACAGCTTGCAAGGACTCTG
Ί 997 Left TTTCTACCAACTTCTGTCAAGCTCT
1979 Left GAAATTGTGTTTGTTGAAAGGTAGC 998 Right TCTAGAAGAAGCAAACGAAGATGAG
1980 Right ATCTAGAAGAAGCAAACGAAGATGA
j 999 Left TTTCTACCAACTTCTGTCAAGCTCT
1981 Left GAAATTGTGTTTGTTGAAAGGTAGC 000 Right CTCCACGAATCACACTGATTATTTA
1982 Right GATCTAGAAGAAGCAAACGAAGATG
EGFR Exon21 100-200 bases
Seq. 016 Right ACACAGCAAAGCAGAAACTCAC
Primer Sequence
ID
2001 Left ACGTCTTCCTTCTCTCTCTGTCATA 017 Left CAGTTAACGTCTTCCTTCTCTCTCT
2002 Right ACACAGCAAAGCAGAAACTCAC 018 Right ACACAGCAAAGCAGAAACTCAC
2003 Left TTAACGTCTTCCTTCTCTCTCTGTC 019 Left AGTTAACGTCTTCCTTCTCTCTCTG
2004 Right ACACAGCAAAGCAGAAACTCAC 020 Right ACACAGCAAAGCAGAAACTCAC
2005 Left TAACGTCTTCCTTCTCTCTCTGTCA 5eq.
Primer Sequence
2006 Right ACACAGCAAAGCAGAAACTCAC ID
021 Left ACGTCTTCCTTCTCTCTCTGTCATA
2007 Left ACGTCTTCCTTCTCTCTCTGTCATA 022 Right CACACAGCAAAGCAGAAACTCA
2008 Right CACACAGCAAAGCAGAAACTCAC
023 Left GTTAACGTCTTCCTTCTCTCTCTGT
2009 Left ACGTCTTCCTTCTCTCTCTGTCAT 024 Right ACACAGCAAAGCAGAAACTCAC
2010 Right ACACAGCAAAGCAGAAACTCAC
025 Left TTAACGTCTTCCTTCTCTCTCTGTC
2011 Left CCAGTTAACGTCTTCCTTCTCTCTC 026 Right CACACAGCAAAGCAGAAACTCAC
2012 Right ACACAGCAAAGCAGAAACTCAC
027 Left GTTAACGTCTTCCTTCTCTCTCTGTC
2013 Left ACGTCTTCCTTCTCTCTCTGTCATA 028 Right ACACAGCAAAGCAGAAACTCAC
2014 Right CCACACAGCAAAGCAGAAACT
029 Left AGTTAACGTCTTCCTTCTCTCTCTGT
2015 Left AACGTCTTCCTTCTCTCTCTGTCAT 030 Right ACACAGCAAAGCAGAAACTCAC
036 Right CACACAGCAAAGCAGAAACTCA
2031 Left TTAACGTCTTCCTTCTCTCTCTGTC
2032 Right CCACACAGCAAAGCAGAAACT 037 Left TAACGTCTTCCTTCTCTCTCTGTCA
038 Right CACACAGCAAAGCAGAAACTCAC
2033 Left CCAGTTAACGTCTTCCTTCTCTCT
2034 Right ACACAGCAAAGCAGAAACTCAC 039 Left CGTCTTCCTTCTCTCTCTGTCATA
040 Right ACACAGCAAAGCAGAAACTCAC
2035 Left TTAACGTCTTCCTTCTCTCTCTGTC
EGFR Exon21 200-400 bases
Seq.
Primer Sequence
ID 061 Left ACGTCTTCCTTCTCTCTCTGTCATA
2041 Left ACGTCTTCCTTCTCTCTCTGTCATA 062 Right AAGTGAACATTTAGGATGTGGAGAT
2042 Right TGTCTCTAAGGGGAGGGAGTTATAC
063 Left ACGTCTTCCTTCTCTCTCTGTCATA
2043 Left ACGTCTTCCTTCTCTCTCTGTCATA 064 Right GTCAAGAAACTAGTGCTGGGTAGAT
2044 Right GAAAGTGAACATTTAGGATGTGGAG
065 Left TTAACGTCTTCCTTCTCTCTCTGTC
2045 Left ACGTCTTCCTTCTCTCTCTGTCATA 066 Right GTGTCAAGAAACTAGTGCTGGGTAG
2046 Right AAAGTGAACATTTAGGATGTGGAGA
067 Left TTAACGTCTTCCTTCTCTCTCTGTC
2047 Left ACGTCTTCCTTCTCTCTCTGTCATA 068 Right AGTGAACATTTAGGATGTGGAGATG
2048 Right AGAAAGTGAACATTTAGGATGTGGA
Seq. 069 Left TTAACGTCTTCCTTCTCTCTCTGTC
Primer Sequence
ID 070 Right AAGTGAACATTTAGGATGTGGAGAT
2049 Left TTAACGTCTTCCTTCTCTCTCTGTC
2050 Right TGTCTCTAAGGGGAGGGAGTTATAC 071 Left ACGTCTTCCTTCTCTCTCTGTCATA
072 Right TCAAGAAACTAGTGCTGGGTAGATG
2051 Left ACGTCTTCCTTCTCTCTCTGTCATA
2052 Right GTGTCAAGAAACTAGTGCTGGGTAG 073 Left TTAACGTCTTCCTTCTCTCTCTGTC
074 Right GTCAAGAAACTAGTGCTGGGTAGAT
2053 Left TTAACGTCTTCCTTCTCTCTCTGTC
2054 Right AAAGTGAACATTTAGGATGTGGAGA 075 Left ACGTCTTCCTTCTCTCTCTGTCATA
GAAAGGGAAAGACATAGAAAGTGAA
Right
2055 Left TTAACGTCTTCCTTCTCTCTCTGTC 076 C
2056 Right GAAAGTGAACATTTAGGATGTGGAG
077 Left ACGTCTTCCTTCTCTCTCTGTCATA
2057 Left TTAACGTCTTCCTTCTCTCTCTGTC 078 Right TGTCAAGAAACTAGTGCTGGGTAG
2058 Right AGAAAGTGAACATTTAGGATGTGGA
079 Left TAACGTCTTCCTTCTCTCTCTGTCA
2059 Left ACGTCTTCCTTCTCTCTCTGTCATA 080 Right TGTCTCTAAGGGGAGGGAGTTATAC
2060 Right AGTGAACATTTAGGATGTGGAGATG
EGFR Exon21 400-1000 bases
Seq.
Primer Sequence
ID 087 Left ACGTCTTCCTTCTCTCTCTGTCATA
2081 Left ACGTCTTCCTTCTCTCTCTGTCATA 088 Right TGAGGTAATAAGTCAGCCATTTTTC
2082 Right CAAAGTAACAATCAACAGACACTGG
089 Left ACGTCTTCCTTCTCTCTCTGTCATA
2083 Left ACGTCTTCCTTCTCTCTCTGTCATA 090 Right CCACAAAGTAACAATCAACAGACAC
2084 Right AAAGATGAGATAACTTGGTGGAGTG
091 Left TTCTAGATCCTCTTTGCATGAAATC
2085 Left ACGTCTTCCTTCTCTCTCTGTCATA 092 Right AAAGATGAGATAACTTGGTGGAGTG
2086 Right CAAAGATGAGATAACTTGGTGGAGT
2093 Left TTCTAGATCCTCTTTGCATGAAATC
2094 Right CAAAGATGAGATAACTTGGTGGAGT 107 Left ACGTCTTCCTTCTCTCTCTGTCATA
108 Right CCATTTCAAAGATGAGATAACTTGG
2095 Left ACGTCTTCCTTCTCTCTCTGTCATA
2096 Right GGTAATAAGTCAGCCATTTTTCCTT 109 Left AGGCTTTACAAGCTTGAGATTCTTT
110 Right CAAAGTAACAATCAACAGACACTGG
2097 Left ACGTCTTCCTTCTCTCTCTGTCATA
2098 Right AATTTCTTTATGCCTCCATTTCTTC 111 Left TTCTAGATCCTCTTTGCATGAAATC
112 Right AATTTCTTTATGCCTCCATTTCTTC
2099 Left ACGTCTTCCTTCTCTCTCTGTCATA
2100 Right GATGAGATAACTTGGTGGAGTGAAT 113 Left ACGTCTTCCTTCTCTCTCTGTCATA
114 Right AGATAACTTGGTGGAGTGAATTGAA
Seq.
Primer Sequence
ID 115 Left TTCTAGATCCTCTTTGCATGAAATC
2101 Left ACGTCTTCCTTCTCTCTCTGTCATA 116 Right GATGAGATAACTTGGTGGAGTGAAT
2102 Right GAATTTTCCAAGAACTTATTCCACA
117 Left TTCTAGATCCTCTTTGCATGAAATC
2103 Left ACGTCTTCCTTCTCTCTCTGTCATA 118 Right CCATTTCAAAGATGAGATAACTTGG
2104 Right TGTGGAATTTTCCAAGAACTTATTC
119 Left AGGCTTTACAAGCTTGAGATTCTTT
2105 Left ACGTCTTCCTTCTCTCTCTGTCATA 120 Right AAAGATGAGATAACTTGGTGGAGTG
2106 Right AATAAGTCAGCCATTTTTCCTTTTC
EGFR Exon22 100-200 bases
Seq. 140 Right CCGTATCTCCCTTCCCTGATTAC
Primer Sequence
ID
2121 Left CACACTGACGTGCCTCTCC 5eq.
Primer Sequence
2122 Right CGTATCTCCCTTCCCTGATTAC ID
141 Left CGAAGCCACACTGACGTG
2123 Left CCACACTGACGTGCCTCTC 142 Right CCGTATCTCCCTTCCCTGATTA
2124 Right CGTATCTCCCTTCCCTGATTAC
143 Left CATGCGAAGCCACACTGAC
2125 Left CACACTGACGTGCCTCTCC 144 Right CGTATCTCCCTTCCCTGATTAC
2126 Right CCGTATCTCCCTTCCCTGATTAC
145 Left CATGCGAAGCCACACTGA
2127 Left CCACACTGACGTGCCTCTC 146 Right CGTATCTCCCTTCCCTGATTAC
2128 Right CCGTATCTCCCTTCCCTGATTAC
147 Left CATGCGAAGCCACACTGAC
2129 Left CACACTGACGTGCCTCTCC 148 Right CCGTATCTCCCTTCCCTGATTAC
2130 Right CCGTATCTCCCTTCCCTGATTA
149 Left CACACTGACGTGCCTCTCC
2131 Left CCACACTGACGTGCCTCTC 150 Right TATCTCCCCTCCCCGTATCT
2132 Right CCGTATCTCCCTTCCCTGATTA
151 Left CATGCGAAGCCACACTGA
2133 Left CGAAGCCACACTGACGTG 152 Right CCGTATCTCCCTTCCCTGATTAC
2134 Right CGTATCTCCCTTCCCTGATTAC
153 Left CACACTGACGTGCCTCTCC
2135 Left CGAAGCCACACTGACGTG 154 Right CCGTATCTCCCTTCCCTGAT
2136 Right CCGTATCTCCCTTCCCTGATTAC
155 Left CCACACTGACGTGCCTCTC
2137 Left ACCATGCGAAGCCACACT 156 Right CCGTATCTCCCTTCCCTGAT
2138 Right CGTATCTCCCTTCCCTGATTAC
157 Left ACCATGCGAAGCCACACT
2139 Left ACCATGCGAAGCCACACT 158 Right CCGTATCTCCCTTCCCTGATTA
160 Right TATCTCCCCTCCCCGTATCTC
2159 Left CACACTGACGTGCCTCTCC
EGFR Exon22 200-400 bases
Seq. 180 Right CCGTATCTCCCTTCCCTGATTAC
Primer Sequence
ID
2161 Left GTATTTTGAAACTCAAGATCGCATT
2162 Right CGTATCTCCCTTCCCTGATTAC
181 Left CCATGAGTACGTATTTTGAAACTCA
2163 Left CCTCCATGAGTACGTATTTTGAAAC 182 Right CATGGCAAACTCTTGCTATCC
2164 Right CGTATCTCCCTTCCCTGATTAC
183 Left TATTTTGAAACTCAAGATCGCATTC
2165 Left GTATTTTGAAACTCAAGATCGCATT 184 Right CGTATCTCCCTTCCCTGATTAC
2166 Right CCGTATCTCCCTTCCCTGATTAC
185 Left GTATTTTGAAACTCAAGATCGCATT
2167 Left CCTCCATGAGTACGTATTTTGAAAC 186 Right CTTATCTCCCCTCCCCGTATCT
2168 Right CCGTATCTCCCTTCCCTGATTAC
187 Left GTATTTTGAAACTCAAGATCGCATT
2169 Left GTATTTTGAAACTCAAGATCGCATT 188 Right ACATATCCCCATGGCAAACTCT
2170 Right CATGGCAAACTCTTGCTATCC
189 Left CTTTTCCTCCATGAGTACGTATTTT
2190 Right CGTATCTCCCTTCCCTGATTAC
Seq. 191 Left TATTTTGAAACTCAAGATCGCATTC
Primer Sequence
ID 192 Right CCGTATCTCCCTTCCCTGATTAC
2171 Left GTATTTTGAAACTCAAGATCGCATT
2172 Right ATATCCCCATGGCAAACTCTT 193 Left GTATTTTGAAACTCAAGATCGCATT
194 Right ACATATCCCCATGGCAAACTCTT
2173 Left CCATGAGTACGTATTTTGAAACTCA
2174 Right CGTATCTCCCTTCCCTGATTAC 195 Left CCTCCATGAGTACGTATTTTGAAAC
196 Right CTTATCTCCCCTCCCCGTATCT
2175 Left GTATTTTGAAACTCAAGATCGCATT
2176 Right CCGTATCTCCCTTCCCTGATTA 197 Left CCATGAGTACGTATTTTGAAACTCA
198 Right CCGTATCTCCCTTCCCTGATTA
2177 Left CCTCCATGAGTACGTATTTTGAAAC
2178 Right CCGTATCTCCCTTCCCTGATTA 199 Left GTATTTTGAAACTCAAGATCGCATT
200 Right ACATATCCCCATGGCAAACTC
2179 Left CCATGAGTACGTATTTTGAAACTCA
EGFR Exon22 400-1000 bases
Seq. 209 Left GTATTTTGAAACTCAAGATCGCATT
Primer Sequence
ID 210 Right ATCCAAAATAAAGGAATGTGTGTGT
2201 Left GTATTTTGAAACTCAAGATCGCATT
2202 Right TTGAATCCAAAATAAAGGAATGTGT 211 Left GTATTTTGAAACTCAAGATCGCATT
212 Right GCTTACCTTGTTATCAAGTCCTGAA
2203 Left GTATTTTGAAACTCAAGATCGCATT
2204 Right CACACTGAGCACTCAATAAAGAGAA 213 Left TGGTCTATTGAAAGAGCTTATCCAG
214 Right TTGAATCCAAAATAAAGGAATGTGT
2205 Left GTATTTTGAAACTCAAGATCGCATT
2206 Right TTCTCCACTACAAATCACCACAGTA 215 Left CCTCCATGAGTACGTATTTTGAAAC
216 Right TTGAATCCAAAATAAAGGAATGTGT
2207 Left GTATTTTGAAACTCAAGATCGCATT
2208 Right ATTCTTCAAAGGTAGCTGATTGATG 217 Left CCTCCATGAGTACGTATTTTGAAAC
218 Right CACACTGAGCACTCAATAAAGAGAA
229 Left GTATTTTGAAACTCAAGATCGCATT
2219 Left CCTCCATGAGTACGTATTTTGAAAC 230 Right TATTCCTTCTCCACTACAAATCACC
2220 Right TTCTCCACTACAAATCACCACAGTA
231 Left GTATTTTGAAACTCAAGATCGCATT
Seq. 232 Right CCACTACAAATCACCACAGTATTCA
Primer Sequence
ID
2221 Left TGGTCTATTGAAAGAGCTTATCCAG 233 Left GTATTTTGAAACTCAAGATCGCATT
2222 Right ATCCAAAATAAAGGAATGTGTGTGT 234 Right CTTGATTGAATCCAAAATAAAGGAA
2223 Left CCTCCATGAGTACGTATTTTGAAAC 235 Left GTATTTTGAAACTCAAGATCGCATT
2224 Right ATCCAAAATAAAGGAATGTGTGTGT 236 Right TAAGAACAGAGACATCAGACCACAC
2225 Left CCTCCATGAGTACGTATTTTGAAAC 237 Left CCTCCATGAGTACGTATTTTGAAAC
2226 Right GCTTACCTTGTTATCAAGTCCTGAA 238 Right CAAAGGTAGCTGATTGATGAGAGTT
2227 Left GTATTTTGAAACTCAAGATCGCATT 239 Left GTATTTTGAAACTCAAGATCGCATT
2228 Right CAAAGGTAGCTGATTGATGAGAGTT 240 Right AAATTCTTCAAAGGTAGCTGATTGA
EGFR Exonl8-19 2kb
Seq.
Primer Sequence
ID 2 261 Left AATCTCCAAAATATATGCCAAAGAA
2241 Left ATGCCAAAGAAGTAGAATGAGAAAA 2 262 Right GGGTATAACTGCACATTCAGAGATT
2242 Right AACATGTCACCAACTGGGTATAACT
Seq. 2 263 Left AAATCTCCAAAATATATGCCAAAGA
Primer Sequence
ID 2 264 Right GGGTATAACTGCACATTCAGAGATT
2243 Left ATGCCAAAGAAGTAGAATGAGAAAA
2244 Right GGGTATAACTGCACATTCAGAGATT 2 265 Left ATCTCCAAAATATATGCCAAAGAAG
2 266 Right AACATGTCACCAACTGGGTATAACT
2245 Left TCTCCAAAATATATGCCAAAGAAGT
2246 Right AACATGTCACCAACTGGGTATAACT 2 267 Left AAAAATCTCCAAAATATATGCCAAAG
2 268 Right AACATGTCACCAACTGGGTATAACT
2247 Left TGCCAAAGAAGTAGAATGAGAAAAA
2248 Right AACATGTCACCAACTGGGTATAACT 2 269 Left AAAATCTCCAAAATATATGCCAAAG
2 270 Right AACATGTCACCAACTGGGTATAACT
2249 Left AATCTCCAAAATATATGCCAAAGAA
2250 Right AACATGTCACCAACTGGGTATAACT 2 271 Left ATGCCAAAGAAGTAGAATGAGAAAA
2 272 Right ACTGGGTATAACTGCACATTCAGAG
2251 Left AAATCTCCAAAATATATGCCAAAGA
2252 Right AACATGTCACCAACTGGGTATAACT 2 273 Left ATCTCCAAAATATATGCCAAAGAAG
2 274 Right AACTGCACATTCAGAGATTCTTTCT
2253 Left TCTCCAAAATATATGCCAAAGAAGT
2254 Right AACTGCACATTCAGAGATTCTTTCT 2 275 Left AATCTCCAAAATATATGCCAAAGAAG
2 276 Right AACATGTCACCAACTGGGTATAACT
2255 Left TCTCCAAAATATATGCCAAAGAAGT
2256 Right GGGTATAACTGCACATTCAGAGATT 2 277 Left ATCTCCAAAATATATGCCAAAGAAG
2 278 Right GGGTATAACTGCACATTCAGAGATT
2257 Left TGCCAAAGAAGTAGAATGAGAAAAA
2258 Right GGGTATAACTGCACATTCAGAGATT 2 279 Left AAAAATCTCCAAAATATATGCCAAAG
2 280 Right AACTGCACATTCAGAGATTCTTTCT
2259 Left AAATCTCCAAAATATATGCCAAAGA
2260 Right AACTGCACATTCAGAGATTCTTTCT
EGFR Exon20-21 2kb
Seq. 300 Right AAAGATGAGATAACTTGGTGGAGTG
Primer Sequence
ID
2281 Left TTTCTACCAACTTCTGTCAAGCTCT 301 Left AGAAAGAATCTCTGAATGTGCAGTT
2282 Right TGCTATGTATTCTGTGGGTTAGACA 302 Right CAAAGATGAGATAACTTGGTGGAGT
2283 Left TTTCTACCAACTTCTGTCAAGCTCT 303 Left AGAAAGAATCTCTGAATGTGCAGTT
2284 Right TGAGGTAATAAGTCAGCCATTTTTC 304 Right TTTTCCAAGAACTTATTCCACAAAG
2285 Left TTTCTACCAACTTCTGTCAAGCTCT 305 Left AATCTCTGAATGTGCAGTTATACCC
2286 Right GGTAATAAGTCAGCCATTTTTCCTT 306 Right AAAGATGAGATAACTTGGTGGAGTG
2287 Left AGAAAGAATCTCTGAATGTGCAGTT 307 Left AATCTCTGAATGTGCAGTTATACCC
2288 Right CAAAGTAACAATCAACAGACACTGG 308 Right CAAAGATGAGATAACTTGGTGGAGT
2289 Left TTTCTACCAACTTCTGTCAAGCTCT
2290 Right ATAAAGGCCCATGTTCTCTTTACTT
309 Left TTTCTACCAACTTCTGTCAAGCTCT
2291 Left TTTCTACCAACTTCTGTCAAGCTCT 310 Right AATAAGTCAGCCATTTTTCCTTTTC
2292 Right CCTTCTTGGCTGTAAGATCAACTAA
311 Left TTTCTACCAACTTCTGTCAAGCTCT
2293 Left AATCTCTGAATGTGCAGTTATACCC 312 Right CTGCCCAGAGAAAATTAAACTGTAG
2294 Right CAAAGTAACAATCAACAGACACTGG
313 Left AATCTCTGAATGTGCAGTTATACCC
2314 Right TTTTCCAAGAACTTATTCCACAAAG
Seq. 315 Left GTTTCTACCAACTTCTGTCAAGCTC
Primer Sequence
ID 316 Right GGTAATAAGTCAGCCATTTTTCCTT
2295 Left TTTCTACCAACTTCTGTCAAGCTCT
2296 Right ATTACTCTCTGGCTTTTGTCCTTCT 317 Left TGTGTTTCTACCAACTTCTGTCAAG
318 Right TGCTATGTATTCTGTGGGTTAGACA
2297 Left GTTTCTACCAACTTCTGTCAAGCTC
2298 Right TGAGGTAATAAGTCAGCCATTTTTC 319 Left GTTTCTACCAACTTCTGTCAAGCTC
320 Right ATAAAGGCCCATGTTCTCTTTACTT
2299 Left AGAAAGAATCTCTGAATGTGCAGTT
EGFR Exon22 2kb
Seq. 331 Left GTCTGTAGGTTACACACAAATGCTG
Primer Sequence
ID 332 Right TTCTCCACTACAAATCACCACAGTA
2321 Left CACATAGCATTTGCACTGTATTAGG
2322 Right TTGAATCCAAAATAAAGGAATGTGT 333 Left AGGTAATCAGGAGATGCTGTAGATG
334 Right CACACTGAGCACTCAATAAAGAGAA
2323 Left ATTTTGATATTTAAGGGAGGTCCTG
2324 Right TTCTCCACTACAAATCACCACAGTA 335 Left GTCTGTAGGTTACACACAAATGCTG
336 Right ATTCTTCAAAGGTAGCTGATTGATG
2325 Left CACATAGCATTTGCACTGTATTAGG
2326 Right TTCTCCACTACAAATCACCACAGTA 337 Left ATTTTGATATTTAAGGGAGGTCCTG
338 Right GCTTACCTTGTTATCAAGTCCTGAA
2327 Left GTCTGTAGGTTACACACAAATGCTG
2328 Right CACACTGAGCACTCAATAAAGAGAA 339 Left CACATAGCATTTGCACTGTATTAGG
340 Right GCTTACCTTGTTATCAAGTCCTGAA
2329 Left CACATAGCATTTGCACTGTATTAGG
2330 Right ATTCTTCAAAGGTAGCTGATTGATG 5eq.
Primer Sequence
ID
2341 Left AGGTAATCAGGAGATGCTGTAGATG 351 Left CTCTGAGAAAGAGTCTGCTAAGGAA
2342 Right ATTCTTCAAAGGTAGCTGATTGATG 352 Right TTGAATCCAAAATAAAGGAATGTGT
2343 Left GTCTGTAGGTTACACACAAATGCTG 353 Left TCGGTACTGAACATATACGGACTTT
2344 Right GCTTACCTTGTTATCAAGTCCTGAA 354 Right TTGAATCCAAAATAAAGGAATGTGT
2345 Left AGGTAATCAGGAGATGCTGTAGATG 355 Left TCGGTACTGAACATATACGGACTTT
2346 Right GCTTACCTTGTTATCAAGTCCTGAA 356 Right CACACTGAGCACTCAATAAAGAGAA
2347 Left GTATTTTGAAACTCAAGATCGCATT 357 Left CACATAGCATTTGCACTGTATTAGG
2348 Right TTATACACATAGCGGAGTGATCAAA 358 Right CAAAGGTAGCTGATTGATGAGAGTT
2349 Left TCTGAGAAAGAGTCTGCTAAGGAAG 359 Left TCTGAGAAAGAGTCTGCTAAGGAAG
2350 Right TTGAATCCAAAATAAAGGAATGTGT 360 Right ATCCAAAATAAAGGAATGTGTGTGT
EGFR Exonl8-21 5kb
Seq.
Primer Sequence
ID 379 Left TGCCAAAGAAGTAGAATGAGAAAAA
2361 Left ATGCCAAAGAAGTAGAATGAGAAAA 380 Right TGCTATGTATTCTGTGGGTTAGACA
2362 Right TGCTATGTATTCTGTGGGTTAGACA
381 Left ATGCCAAAGAAGTAGAATGAGAAAA
2363 Left ATGCCAAAGAAGTAGAATGAGAAAA 382 Right AGACATTTTTATAAAGGCCCATGTT
2364 Right CCTTCTTGGCTGTAAGATCAACTAA
383 Left ATGCCAAAGAAGTAGAATGAGAAAA
2384 Right ATTGTAAGTGAAAGGCTTCACAGAT
Seq. 385 Left TCTCCAAAATATATGCCAAAGAAGT
Primer Sequence
ID 386 Right GGTAATAAGTCAGCCATTTTTCCTT
2365 Left ATGCCAAAGAAGTAGAATGAGAAAA
2366 Right GTGCACTTAACTTTTAAGCCTTGAC 387 Left AATCTCCAAAATATATGCCAAAGAA
388 Right ATCTATCTTCTACCCCATTTCCAAC
2367 Left ATGCCAAAGAAGTAGAATGAGAAAA
2368 Right AGATTGTAAGTGAAAGGCTTCACAG 389 Left AAATCTCCAAAATATATGCCAAAGA
390 Right ATCTATCTTCTACCCCATTTCCAAC
2391 Left AAATCTCCAAAATATATGCCAAAGA
2369 Left TCTCCAAAATATATGCCAAAGAAGT 392 Right TGCTATGTATTCTGTGGGTTAGACA
2370 Right ATCTATCTTCTACCCCATTTCCAAC
393 Left TCTCCAAAATATATGCCAAAGAAGT
2371 Left ATGCCAAAGAAGTAGAATGAGAAAA 394 Right CCTTCTTGGCTGTAAGATCAACTAA
2372 Right CTGCCCAGAGAAAATTAAACTGTAG
395 Left TCTCCAAAATATATGCCAAAGAAGT
2373 Left TCTCCAAAATATATGCCAAAGAAGT 396 Right GTGCACTTAACTTTTAAGCCTTGAC
2374 Right TGCTATGTATTCTGTGGGTTAGACA
397 Left AATCTCCAAAATATATGCCAAAGAA
2375 Left TGCCAAAGAAGTAGAATGAGAAAAA 398 Right TGAGGTAATAAGTCAGCCATTTTTC
2376 Right ATCTATCTTCTACCCCATTTCCAAC
399 Left AAATCTCCAAAATATATGCCAAAGA
2377 Left TCTCCAAAATATATGCCAAAGAAGT 400 Right TGAGGTAATAAGTCAGCCATTTTTC
2378 Right TGAGGTAATAAGTCAGCCATTTTTC
EGFR Exon22 5kb
Seq. Primer Sequence ID
2401 Left GTTGGAAATGGGGTAGAAGATAGAT 421 Left CACATAGCATTTGCACTGTATTAGG
2402 Right TTGAATCCAAAATAAAGGAATGTGT 422 Right GGGTCAAATAAACCTCCACTTATCT
2403 Left GTTGGAAATGGGGTAGAAGATAGAT 423 Left GTTGGAAATGGGGTAGAAGATAGAT
2404 Right CACACTGAGCACTCAATAAAGAGAA 424 Right ATTCTTCAAAGGTAGCTGATTGATG
2405 Left ATTTTGATATTTAAGGGAGGTCCTG 425 Left ATTTTGATATTTAAGGGAGGTCCTG
2406 Right CTCTCCCATCAACATTTAGAAGAAA 426 Right TATAAGCCAATAAATCCCATTTTGA
2407 Left CACATAGCATTTGCACTGTATTAGG 427 Left CACATAGCATTTGCACTGTATTAGG
2408 Right CTCTCCCATCAACATTTAGAAGAAA 428 Right TATAAGCCAATAAATCCCATTTTGA
2409 Left ATTTTGATATTTAAGGGAGGTCCTG 429 Left GTCTGTAGGTTACACACAAATGCTG
2410 Right TACAACAAACACAAGAATGGCTTTA 430 Right TACAACAAACACAAGAATGGCTTTA
2411 Left CACATAGCATTTGCACTGTATTAGG 431 Left TACAGATTATGATGACTGCCTCAAA
2412 Right TACAACAAACACAAGAATGGCTTTA 432 Right TACAACAAACACAAGAATGGCTTTA
2413 Left GTTGGAAATGGGGTAGAAGATAGAT 433 Left AGGAAAATAACACACACTCTCCTTG
2414 Right TTCTCCACTACAAATCACCACAGTA 434 Right TTACTGGGAGATGATTAAGAACAGC
2415 Left ATATCTGAATAAAAGGTCACCACCA 435 Left GTCTGTAGGTTACACACAAATGCTG
2416 Right CTCTCCCATCAACATTTAGAAGAAA 436 Right GGGTCAAATAAACCTCCACTTATCT
2417 Left CCATATCTGAATAAAAGGTCACCAC 437 Left ATATCTGAATAAAAGGTCACCACCA
2418 Right CTCTCCCATCAACATTTAGAAGAAA 438 Right TATAAGCCAATAAATCCCATTTTGA
Seq.
Primer Sequence
ID 439 Left CCATATCTGAATAAAAGGTCACCAC
2419 Left TATCTGAATAAAAGGTCACCACCAT 440 Right TATAAGCCAATAAATCCCATTTTGA
2420 Right CTCTCCCATCAACATTTAGAAGAAA
Table 9. KIT Capture Primer List for NGS Panel
KIT Exon8 150-175 bases
Seq. 452 Right ATAAGCAGTGCCAAAAATAATCATC
Primer Sequence
ID
2441 Left ATATGGCCATTTCTGTTTTCCTGTA 453 Left TGACATATGGCCATTTCTGTTTT
2442 Right ATAAGCAGTGCCAAAAATAATCATC 454 Right ATAAGCAGTGCCAAAAATAATCATC
2443 Left CTGACATATGGCCATTTCTGTTT 455 Left ATATGGCCATTTCTGTTTTCCTGTA
2444 Right ATAAGCAGTGCCAAAAATAATCATC 456 Right TTATAAGCAGTGCCAAAAATAATCA
2445 Left GACATATGGCCATTTCTGTTTTC 457 Left TATGGCCATTTCTGTTTTCCTGTA
2446 Right ATAAGCAGTGCCAAAAATAATCATC 458 Right ATAAGCAGTGCCAAAAATAATCATC
2447 Left CTGACATATGGCCATTTCTGTTTT 459 Left GACATATGGCCATTTCTGTTTTC
2448 Right ATAAGCAGTGCCAAAAATAATCATC 460 Right TTATAAGCAGTGCCAAAAATAATCA
2449 Left ATATGGCCATTTCTGTTTTCCTGTA 5eq.
Primer Sequence
2450 Right GCATTATAAGCAGTGCCAAAAATAA ID
461 Left CTGACATATGGCCATTTCTGTTTTC
2451 Left TATGGCCATTTCTGTTTTCCTGTAG 462 Right ATAAGCAGTGCCAAAAATAATCATC
2463 Left ATATGGCCATTTCTGTTTTCCTGTA 473 Left TATGGCCATTTCTGTTTTCCTGTAG
2464 Right TATAAGCAGTGCCAAAAATAATCATC 474 Right TTATAAGCAGTGCCAAAAATAATCA
2465 Left GGCCATTTCTGTTTTCCTGTAG 475 Left TGACATATGGCCATTTCTGTTTTC
2466 Right ATAAGCAGTGCCAAAAATAATCATC 476 Right ATAAGCAGTGCCAAAAATAATCATC
2467 Left TATGGCCATTTCTGTTTTCCTGTAG 477 Left ATATGGCCATTTCTGTTTTCCTGTA
2468 Right GCATTATAAGCAGTGCCAAAAATAA 478 Right TAAGCAGTGCCAAAAATAATCATC
2469 Left ATATGGCCATTTCTGTTTTCCTGT 479 Left GACATATGGCCATTTCTGTTTTC
2470 Right ATAAGCAGTGCCAAAAATAATCATC 480 Right TATAAGCAGTGCCAAAAATAATCATC
2471 Left ACATATGGCCATTTCTGTTTTCCT
2472 Right ATAAGCAGTGCCAAAAATAATCATC
KIT Exon8 176-200 bases
Seq.
Primer Sequence
ID 501 Left GACATATGGCCATTTCTGTTTTC
2481 Left AGGTTTTCCAGCACTCTGACATA 502 Right GCATTATAAGCAGTGCCAAAAATAA
2482 Right ATAAGCAGTGCCAAAAATAATCATC
503 Left AGGTTTTCCAGCACTCTGACATA
2483 Left ACTCTGACATATGGCCATTTCTGTT 504 Right TTATAAGCAGTGCCAAAAATAATCA
2484 Right ATAAGCAGTGCCAAAAATAATCATC
505 Left ACTCTGACATATGGCCATTTCTGTT
2485 Left CTGACATATGGCCATTTCTGTTT 506 Right TTATAAGCAGTGCCAAAAATAATCA
2486 Right ATAAGCAGTGCCAAAAATAATCATC
507 Left GAGGTTTTCCAGCACTCTGACATA
2487 Left CTGACATATGGCCATTTCTGTTTT 508 Right ATAAGCAGTGCCAAAAATAATCATC
2488 Right ATAAGCAGTGCCAAAAATAATCATC
Seq. 509 Left CTGACATATGGCCATTTCTGTTT
Primer Sequence
ID 510 Right TTATAAGCAGTGCCAAAAATAATCA
2489 Left ATATGGCCATTTCTGTTTTCCTGTA
2490 Right GCATTATAAGCAGTGCCAAAAATAA 51 1 Left TCTGACATATGGCCATTTCTGTTT
512 Right ATAAGCAGTGCCAAAAATAATCATC
2491 Left CTCTGACATATGGCCATTTCTGTT
2492 Right ATAAGCAGTGCCAAAAATAATCATC 513 Left GACATATGGCCATTTCTGTTTTC
514 Right TTATAAGCAGTGCCAAAAATAATCA
2493 Left CTCTGACATATGGCCATTTCTGTTT
2494 Right ATAAGCAGTGCCAAAAATAATCATC 515 Left CTGACATATGGCCATTTCTGTTTTC
516 Right ATAAGCAGTGCCAAAAATAATCATC
2495 Left AGGTTTTCCAGCACTCTGACATA
2496 Right GCATTATAAGCAGTGCCAAAAATAA 517 Left TCTGACATATGGCCATTTCTGTTTT
518 Right ATAAGCAGTGCCAAAAATAATCATC
2497 Left ACTCTGACATATGGCCATTTCTGTT
2498 Right GCATTATAAGCAGTGCCAAAAATAA 519 Left CTGACATATGGCCATTTCTGTTTT
520 Right TTATAAGCAGTGCCAAAAATAATCA
2499 Left TCTGACATATGGCCATTTCTGTT
2500 Right ATAAGCAGTGCCAAAAATAATCATC
KIT Exon8 201-300 bases
Seq. 7 522 Right ATAAGCAGTGCCAAAAATAATCATC
Primer Sequence
ID
2521 Left TTAGAGAGGGAGTGAAGTGAATGTT 7 523 Left GATTAGAGAGGGAGTGAAGTGAATG
2589 Left TAGAGAGGGAGTGAAGTGAATGTTG 2595 Left TAGAGAGGGAGTGAAGTGAATGTTG
2590 Right TCATTCAGTAATGATTTTTCAGCAA 2 596 Right TTCAGTAATGATTTTTCAGCAAACA
2591 Left ATTAGAGAGGGAGTGAAGTGAATGT' Γ2 597 Left ATTAGAGAGGGAGTGAAGTGAATGTT
2592 Right TCATTCAGTAATGATTTTTCAGCAA 2 598 Right TCAGTAATGATTTTTCAGCAAACAA
2593 Left TAGAGAGGGAGTGAAGTGAATGTTG 2 599 Left CAGGAAGGTTGTAGGGATTAGAGAG
2594 Right TCAGTAATGATTTTTCAGCAAACAA 2 600 Right AATTATCCCTTCTAAAAAGCCACAT
KIT Exon8 401-500 bases
Seq. 620 Right AAATTGCATGATAAATCCAGAAAGA
Primer Sequence
ID
2601 Left GATTAGAGAGGGAGTGAAGTGAATG 621 Left GGATTAGAGAGGGAGTGAAGTGAAT
2602 Right TCATTCAGTAATGATTTTTCAGCAA 622 Right GAAATTGCATGATAAATCCAGAAAG
2603 Left GGATTAGAGAGGGAGTGAAGTGAAT 623 Left GTAGGGATTAGAGAGGGAGTGAAGT
2604 Right TCATTCAGTAATGATTTTTCAGCAA 624 Right AAATTGCATGATAAATCCAGAAAGA
2605 Left GTAGGGATTAGAGAGGGAGTGAAGT 625 Left GTAGGGATTAGAGAGGGAGTGAAGT
2606 Right TCATTCAGTAATGATTTTTCAGCAA 626 Right GAAATTGCATGATAAATCCAGAAAG
2607 Left GTAGGGATTAGAGAGGGAGTGAAGT 627 Left TTAGAAGCAGTCTTCAGATCCCTAC
2608 Right TCAGTAATGATTTTTCAGCAAACAA 628 Right ATAAGCAGTGCCAAAAATAATCATC
2609 Left GTAGGGATTAGAGAGGGAGTGAAGT 629 Left GATTAGAGAGGGAGTGAAGTGAATG
2610 Right TTCAGTAATGATTTTTCAGCAAACA 630 Right GTCATTCAGTAATGATTTTTCAGCA
2611 Left TTAGAGAGGGAGTGAAGTGAATGTT 631 Left GGATTAGAGAGGGAGTGAAGTGAAT
2612 Right AAATTGCATGATAAATCCAGAAAGA 632 Right GTCATTCAGTAATGATTTTTCAGCA
Seq. 633 Left AGATTTTTACCTGTGGAACACTTTG
Primer Sequence
ID 634 Right GCATTATAAGCAGTGCCAAAAATAA
2613 Left TTAGAGAGGGAGTGAAGTGAATGTT
2614 Right GAAATTGCATGATAAATCCAGAAAG 635 Left GTAGGGATTAGAGAGGGAGTGAAGT
636 Right GTCATTCAGTAATGATTTTTCAGCA
2615 Left GATTAGAGAGGGAGTGAAGTGAATG
2616 Right AAATTGCATGATAAATCCAGAAAGA 637 Left CAGGAAGGTTGTAGGGATTAGAGAG
638 Right TCATTCAGTAATGATTTTTCAGCAA
2617 Left GATTAGAGAGGGAGTGAAGTGAATG
2618 Right GAAATTGCATGATAAATCCAGAAAG 639 Left CTCAGGAAGGTTGTAGGGATTAGAG
640 Right TCATTCAGTAATGATTTTTCAGCAA
2619 Left GGATTAGAGAGGGAGTGAAGTGAAT
KIT Exon8 501-600 bases
Seq. 646 Right CGATCATTACTTTTTGGTAACTTGG
Primer Sequence
ID
2641 Left TTAGAGAGGGAGTGAAGTGAATGTT 647 Left TTAGAGAGGGAGTGAAGTGAATGTT
2642 Right CGATCATTACTTTTTGGTAACTTGG 648 Right CATTACTTTTTGGTAACTTGGCAAT
2643 Left GATTAGAGAGGGAGTGAAGTGAATG 649 Left TTAGAGAGGGAGTGAAGTGAATGTT
2644 Right CGATCATTACTTTTTGGTAACTTGG 650 Right GCGATCATTACTTTTTGGTAACTTG
2645 Left GGATTAGAGAGGGAGTGAAGTGAAT 651 Left TTAGAGAGGGAGTGAAGTGAATGTT
2652 Right TGCGATCATTACTTTTTGGTAACTT 666 Right ATAAGCAGTGCCAAAAATAATCATC
2653 Left GATTAGAGAGGGAGTGAAGTGAATG 667 Left TTAGAAGCAGTCTTCAGATCCCTAC
2654 Right CATTACTTTTTGGTAACTTGGCAAT 668 Right AATTATCCCTTCTAAAAAGCCACAT
2655 Left GATTAGAGAGGGAGTGAAGTGAATG 669 Left TTAGAGAGGGAGTGAAGTGAATGTT
2656 Right GCGATCATTACTTTTTGGTAACTTG 670 Right GATAACTACAGTCACATTTCCCACA
2657 Left GGATTAGAGAGGGAGTGAAGTGAAT 671 Left AACAACTCCTAATTTCATCCATTCC
2658 Right CATTACTTTTTGGTAACTTGGCAAT 672 Right ATAAGCAGTGCCAAAAATAATCATC
2659 Left ACTCCTAATTTCATCCATTCCAGTT 673 Left GATTAGAGAGGGAGTGAAGTGAATG
2660 Right ATAAGCAGTGCCAAAAATAATCATC 674 Right GATAACTACAGTCACATTTCCCACA
Seq. 675 Left TTAGAGAGGGAGTGAAGTGAATGTT
Primer Sequence
ID 676 Right TAACTACAGTCACATTTCCCACACA
2661 Left AACTCCTAATTTCATCCATTCCAGT
2662 Right ATAAGCAGTGCCAAAAATAATCATC 677 Left GGATTAGAGAGGGAGTGAAGTGAAT
678 Right GATAACTACAGTCACATTTCCCACA
2663 Left GTAGGGATTAGAGAGGGAGTGAAGT
2664 Right CATTACTTTTTGGTAACTTGGCAAT 679 Left CACTTTGGAGTCCTAGAGTTTGATT
680 Right AATTATCCCTTCTAAAAAGCCACAT
2665 Left GGCAGGAATCCTTTAAAGTAGATTT
KIT Exon8 601-800 bases
Seq.
Primer Sequence
ID 699 Left GGGCTTATCTTTTCCTCTAACAACT
2681 Left AGATTTTTACCTGTGGAACACTTTG 700 Right TCATTCAGTAATGATTTTTCAGCAA
2682 Right TCATTCAGTAATGATTTTTCAGCAA
701 Left GGGCTTATCTTTTCCTCTAACAACT
2683 Left AGATTTTTACCTGTGGAACACTTTG 702 Right TCAGTAATGATTTTTCAGCAAACAA
2684 Right TTCAGTAATGATTTTTCAGCAAACA
Seq. 703 Left GGGCTTATCTTTTCCTCTAACAACT
Primer Sequence
ID 704 Right TTCAGTAATGATTTTTCAGCAAACA
2685 Left AGATTTTTACCTGTGGAACACTTTG
2686 Right TCAGTAATGATTTTTCAGCAAACAA 705 Left AGATTTTTACCTGTGGAACACTTTG
706 Right AATTATCCCTTCTAAAAAGCCACAT
2687 Left GGAGAAAATTCATGTAAGAGCAAAA
2688 Right ATAAGCAGTGCCAAAAATAATCATC 707 Left AGGCTGGTTTTCTTTTCTAGTTTTC
708 Right ATAAGCAGTGCCAAAAATAATCATC
2689 Left AATTCATGTAAGAGCAAAAGAGTGG
2690 Right ATAAGCAGTGCCAAAAATAATCATC 709 Left GGCTGGTTTTCTTTTCTAGTTTTCT
710 Right ATAAGCAGTGCCAAAAATAATCATC
2691 Left GGAGAAAATTCATGTAAGAGCAAAA
2692 Right AATTATCCCTTCTAAAAAGCCACAT 711 Left ACTCCTAATTTCATCCATTCCAGTT
712 Right TCATTCAGTAATGATTTTTCAGCAA
2693 Left AGATTTTTACCTGTGGAACACTTTG
2694 Right AAATTGCATGATAAATCCAGAAAGA 713 Left AACTCCTAATTTCATCCATTCCAGT
714 Right TCATTCAGTAATGATTTTTCAGCAA
2695 Left AGATTTTTACCTGTGGAACACTTTG
2696 Right GAAATTGCATGATAAATCCAGAAAG 715 Left AGGAGAAAATTCATGTAAGAGCAAA
716 Right ATAAGCAGTGCCAAAAATAATCATC
2697 Left AATTCATGTAAGAGCAAAAGAGTGG
2698 Right AATTATCCCTTCTAAAAAGCCACAT 717 Left AAGGAGAAAATTCATGTAAGAGCAA
2718 Right ATAAGCAGTGCCAAAAATAATCATC 719 Left AAAGGAGAAAATTCATGTAAGAGCA
720 Right ATAAGCAGTGCCAAAAATAATCATC
KIT Exon8 801-1000 bases
Seq.
Primer Sequence
ID 741 Left AGGCTGGTTTTCTTTTCTAGTTTTC
2721 Left GGAGAAAATTCATGTAAGAGCAAAA 742 Right TCATTCAGTAATGATTTTTCAGCAA
2722 Right TCATTCAGTAATGATTTTTCAGCAA
743 Left GGCTGGTTTTCTTTTCTAGTTTTCT
2723 Left GGAGAAAATTCATGTAAGAGCAAAA 744 Right TCATTCAGTAATGATTTTTCAGCAA
2724 Right TCAGTAATGATTTTTCAGCAAACAA
745 Left AATTCATGTAAGAGCAAAAGAGTGG
2725 Left GGAGAAAATTCATGTAAGAGCAAAA 746 Right AAATTGCATGATAAATCCAGAAAGA
2726 Right TTCAGTAATGATTTTTCAGCAAACA
747 Left AATTCATGTAAGAGCAAAAGAGTGG
2727 Left AATTCATGTAAGAGCAAAAGAGTGG 748 Right GAAATTGCATGATAAATCCAGAAAG
2728 Right TCATTCAGTAATGATTTTTCAGCAA
749 Left AGATTTTTACCTGTGGAACACTTTG
2729 Left AATTCATGTAAGAGCAAAAGAGTGG 750 Right TGTTGTAATTGTGCGATCATTACTT
2730 Right TCAGTAATGATTTTTCAGCAAACAA
751 Left AGGCTGGTTTTCTTTTCTAGTTTTC
2731 Left AATTCATGTAAGAGCAAAAGAGTGG 752 Right TTCAGTAATGATTTTTCAGCAAACA
2732 Right TTCAGTAATGATTTTTCAGCAAACA
753 Left AGATTTTTACCTGTGGAACACTTTG
2733 Left TTAGAGCATTTCTGCTGTTACAGTG 754 Right CGATCATTACTTTTTGGTAACTTGG
2734 Right ATAAGCAGTGCCAAAAATAATCATC
755 Left TTAGAGAGGGAGTGAAGTGAATGTT
2735 Left GGAGAAAATTCATGTAAGAGCAAAA 756 Right GAACCCTACTTAGTATTCCCCAAAA
2736 Right AAATTGCATGATAAATCCAGAAAGA
757 Left AGGAGAAAATTCATGTAAGAGCAAA
2737 Left GGAGAAAATTCATGTAAGAGCAAAA 758 Right TCATTCAGTAATGATTTTTCAGCAA
2738 Right GAAATTGCATGATAAATCCAGAAAG
Seq. 759 Left AAGGAGAAAATTCATGTAAGAGCAA
Primer Sequence
ID 760 Right TCATTCAGTAATGATTTTTCAGCAA
2739 Left ATACCAAATTAGAGCATTTCTGCTG
2740 Right ATAAGCAGTGCCAAAAATAATCATC
KIT Exon8 2kb
Seq.
Primer Sequence
ID 771 Left AATTCATGTAAGAGCAAAAGAGTGG
2761 Left GGAGAAAATTCATGTAAGAGCAAAA 772 Right GGACTGAAGTTTGAGTTCTAAGCAG
2762 Right GGACTGAAGTTTGAGTTCTAAGCAG
773 Left AATTCATGTAAGAGCAAAAGAGTGG
2763 Left GGAGAAAATTCATGTAAGAGCAAAA 774 Right AGGACTGAAGTTTGAGTTCTAAGCA
2764 Right AGGACTGAAGTTTGAGTTCTAAGCA
775 Left GGAGAAAATTCATGTAAGAGCAAAA
2765 Left TTAGAGCATTTCTGCTGTTACAGTG 776 Right GACCAGAAAATAGTCAAAGTGAGGA
2766 Right CCTGTTTCCTTTCTTAACACCTACA
777 Left TTCTGATCTGTCAGTCTTTCCTTCT
2767 Left GGAGAAAATTCATGTAAGAGCAAAA 778 Right TCATTCAGTAATGATTTTTCAGCAA
2768 Right CCTGTTTCCTTTCTTAACACCTACA
779 Left ATACCAAATTAGAGCATTTCTGCTG
2769 Left AATTCATGTAAGAGCAAAAGAGTGG 780 Right CCTGTTTCCTTTCTTAACACCTACA
2770 Right ACTGAAGTTTGAGTTCTAAGCAGGA
Seq.
Primer Sequence
ID 791 Left AATTCATGTAAGAGCAAAAGAGTGG
2781 Left TTAGAGCATTTCTGCTGTTACAGTG 792 Right GACCAGAAAATAGTCAAAGTGAGGA
2782 Right GCTATTCCCTGTTTCCTTTCTTAAC
793 Left TTCCTTCTCACTGCATATATTTTCC
2783 Left ATAAGTGCATCTTCCTTTCACTTTG 794 Right TCATTCAGTAATGATTTTTCAGCAA
2784 Right GAACCCTACTTAGTATTCCCCAAAA
795 Left ATACCAAATTAGAGCATTTCTGCTG
2785 Left GGAGAAAATTCATGTAAGAGCAAAA 796 Right GCTATTCCCTGTTTCCTTTCTTAAC
2786 Right GCTATTCCCTGTTTCCTTTCTTAAC
797 Left TGAAATTGGTTATCCAAGAAAGGTA
2787 Left TTCTGATCTGTCAGTCTTTCCTTCT 798 Right TCATTCAGTAATGATTTTTCAGCAA
2788 Right TTCAGTAATGATTTTTCAGCAAACA
799 Left AGATTTTTACCTGTGGAACACTTTG
2789 Left TTCTGATCTGTCAGTCTTTCCTTCT 800 Right ACTGAAGTTTGAGTTCTAAGCAGGA
2790 Right TCAGTAATGATTTTTCAGCAAACAA
JOT Exon8-9 5kb
Seq.
Primer Sequence
ID 821 Left AGTTGCCCATGATAATTAAATGAAA
2801 Left AGTTGCCCATGATAATTAAATGAAA 822 Right GCTTCCTTTATGGACGGTTTATATT
2802 Right AGGCAGTGTTAACTTTTGGATACAG
823 Left CCCATGATAATTAAATGAAACTTGC
2803 Left CCCATGATAATTAAATGAAACTTGC 824 Right GCTTCCTTTATGGACGGTTTATATT
2804 Right AGGCAGTGTTAACTTTTGGATACAG
825 Left TGCCCATGATAATTAAATGAAACTT
2805 Left GCCCATGATAATTAAATGAAACTTG 826 Right GCTTCCTTTATGGACGGTTTATATT
2806 Right AGGCAGTGTTAACTTTTGGATACAG
827 Left TTGCCCATGATAATTAAATGAAACT
2807 Left TGCCCATGATAATTAAATGAAACTT 828 Right CCCCTTAAATTGGATTAAAAAGAAA
2808 Right AGGCAGTGTTAACTTTTGGATACAG
829 Left AGTTGCCCATGATAATTAAATGAAA
2809 Left TTGCCCATGATAATTAAATGAAACT 830 Right CCCCTTAAATTGGATTAAAAAGAAA
2810 Right AGGCAGTGTTAACTTTTGGATACAG
Seq. 831 Left GCCCATGATAATTAAATGAAACTTG
Primer Sequence
ID 832 Right CCCCTTAAATTGGATTAAAAAGAAA
2811 Left AGTTTAGGCTTGCTTAGAAAAGGAG
2812 Right AGGCAGTGTTAACTTTTGGATACAG 833 Left CCCATGATAATTAAATGAAACTTGC
834 Right CCCCTTAAATTGGATTAAAAAGAAA
2813 Left AGAGTTTAGGCTTGCTTAGAAAAGG
2814 Right AGGCAGTGTTAACTTTTGGATACAG 835 Left TGCCCATGATAATTAAATGAAACTT
836 Right CCCCTTAAATTGGATTAAAAAGAAA
2815 Left GATTTCTTGTGTCGTGTCCTACTTT
2816 Right AGGCAGTGTTAACTTTTGGATACAG 837 Left AGTTTAGGCTTGCTTAGAAAAGGAG
838 Right CCCCTTAAATTGGATTAAAAAGAAA
2817 Left GCCCATGATAATTAAATGAAACTTG
2818 Right GCTTCCTTTATGGACGGTTTATATT 839 Left AGAGTTTAGGCTTGCTTAGAAAAGG
840 Right CCCCTTAAATTGGATTAAAAAGAAA
2819 Left TTGCCCATGATAATTAAATGAAACT
2820 Right GCTTCCTTTATGGACGGTTTATATT
KIT Exon9 200-250 bases
Seq. 841 Left GGCTTTTGTTTTCTTCCCTTTAG
Primer Sequence
2904 Right ATCCCCTTAAATTGGATTAAAAAGA 914 Right AACATCCCCTTAAATTGGATTAAAA
2905 Left CCACATCCCAAGTGTTTTATGTATT 915 Left CTAGAGTAAGCCAGGGCTTTTGTT
2906 Right CCCCTTAAATTGGATTAAAAAGAA 916 Right AACATCCCCTTAAATTGGATTAAAA
2907 Left GGCTTTTGTTTTCTTCCCTTTAG 917 Left CCACATCCCAAGTGTTTTATGTATT
2908 Right TATGGTAGACAGAGCCTAAACATCC 918 Right TCCCCTTAAATTGGATTAAAAAGAAA
2909 Left CTAGAGTAAGCCAGGGCTTTTGTTT 919 Left GGCTTTTGTTTTCTTCCCTTTAG
2910 Right TATGGTAGACAGAGCCTAAACATCC 920 Right TCATGACTGATATGGTAGACAGAGC
2911 Left CTAGAGTAAGCCAGGGCTTTTGTT
2912 Right TATGGTAGACAGAGCCTAAACATCC
KIT Exon9 301-400 bases
Seq.
Primer Sequence
ID 941 Left TTTGTTTTAAAAGTATGCCACATCC
2921 Left CTCACTAGGTCACCAAAGTGCTTAT 942 Right TATGGTAGACAGAGCCTAAACATCC
2922 Right CCCCTTAAATTGGATTAAAAAGAAA
943 Left CTCACTAGGTCACCAAAGTGCTTAT
2923 Left CTCACTAGGTCACCAAAGTGCTTAT 944 Right ATCCCCTTAAATTGGATTAAAAAGA
2924 Right AACATCCCCTTAAATTGGATTAAAA
945 Left CCACATCCCAAGTGTTTTATGTATT
2925 Left CCACATCCCAAGTGTTTTATGTATT 946 Right TCATGACTGATATGGTAGACAGAGC
2926 Right TATGGTAGACAGAGCCTAAACATCC
947 Left CACTAGGTCACCAAAGTGCTTATTC
2927 Left CTCACTAGGTCACCAAAGTGCTTAT 948 Right AACATCCCCTTAAATTGGATTAAAA
2928 Right CATCCCCTTAAATTGGATTAAAAAG
949 Left TCACTAGGTCACCAAAGTGCTTATT
2929 Left CCACATCCCAAGTGTTTTATGTATT 950 Right AACATCCCCTTAAATTGGATTAAAA
2930 Right GTGATGCATGTATTACCAGAAATGA
951 Left TTTGTTTTAAAAGTATGCCACATCC
2931 Left CCACATCCCAAGTGTTTTATGTATT 952 Right GTGATGCATGTATTACCAGAAATGA
2932 Right AACATCCCCTTAAATTGGATTAAAA
Seq. 953 Left TCACCAAAGTGCTTATTCTTAGACA
Primer Sequence
ID 954 Right CCCCTTAAATTGGATTAAAAAGAAA
2933 Left CACTAGGTCACCAAAGTGCTTATTC
2934 Right CCCCTTAAATTGGATTAAAAAGAAA 955 Left ACTCACTAGGTCACCAAAGTGCTTA
956 Right CCCCTTAAATTGGATTAAAAAGAAA
2935 Left TCACTAGGTCACCAAAGTGCTTATT
2936 Right CCCCTTAAATTGGATTAAAAAGAAA 957 Left TTTGTTTTAAAAGTATGCCACATCC
958 Right AACATCCCCTTAAATTGGATTAAAA
2937 Left CTCACTAGGTCACCAAAGTGCTTAT
2938 Right TCCCCTTAAATTGGATTAAAAAGAA 959 Left AGGTCACCAAAGTGCTTATTCTTAG
960 Right CCCCTTAAATTGGATTAAAAAGAAA
2939 Left TTTGTTTTAAAAGTATGCCACATCC
2940 Right CCCCTTAAATTGGATTAAAAAGAAA
KIT Exon9 401-500 bases
Seq. 962 Right TATGGTAGACAGAGCCTAAACATCC
Primer Sequence
ID
2961 Left CTCACTAGGTCACCAAAGTGCTTAT 963 Left TACAGTCGTAGAAACTCAGTGTTGG
2964 Right CCCCTTAAATTGGATTAAAAAGAAA 982 Right GTGATGCATGTATTACCAGAAATGA
2965 Left CTCACTAGGTCACCAAAGTGCTTAT 983 Left TCACTAGGTCACCAAAGTGCTTATT
2966 Right GTGATGCATGTATTACCAGAAATGA 984 Right GTGATGCATGTATTACCAGAAATGA
2967 Left CTCACTAGGTCACCAAAGTGCTTAT 985 Left TACAGTCGTAGAAACTCAGTGTTGG
2968 Right TCATGACTGATATGGTAGACAGAGC 986 Right ATCCCCTTAAATTGGATTAAAAAGA
2969 Left TACAGTCGTAGAAACTCAGTGTTGG 987 Left TCACCAAAGTGCTTATTCTTAGACA
2970 Right CATCCCCTTAAATTGGATTAAAAAG 988 Right TATGGTAGACAGAGCCTAAACATCC
2971 Left CACTAGGTCACCAAAGTGCTTATTC 989 Left ACTCACTAGGTCACCAAAGTGCTTA
2972 Right TATGGTAGACAGAGCCTAAACATCC 990 Right TATGGTAGACAGAGCCTAAACATCC
2973 Left TCACTAGGTCACCAAAGTGCTTATT 991 Left ACAGTCGTAGAAACTCAGTGTTGGT
2974 Right TATGGTAGACAGAGCCTAAACATCC 992 Right AACATCCCCTTAAATTGGATTAAAA
2975 Left ACAGTCGTAGAAACTCAGTGTTGGT 993 Left CTAGGTCACCAAAGTGCTTATTCTT
2976 Right CCCCTTAAATTGGATTAAAAAGAAA 994 Right TATGGTAGACAGAGCCTAAACATCC
2977 Left TACAGTCGTAGAAACTCAGTGTTGG 995 Left AGGTCACCAAAGTGCTTATTCTTAG
2978 Right TCCCCTTAAATTGGATTAAAAAGAA 996 Right TATGGTAGACAGAGCCTAAACATCC
2979 Left CTCACTAGGTCACCAAAGTGCTTAT 997 Left TCACCAAAGTGCTTATTCTTAGACA
2980 Right GGTCAATGTTGGAATGAACTTAAAA 998 Right GTGATGCATGTATTACCAGAAATGA
Seq. 999 Left CACTAGGTCACCAAAGTGCTTATTC
Primer Sequence
ID 000 Right TCATGACTGATATGGTAGACAGAGC
2981 Left CACTAGGTCACCAAAGTGCTTATTC
KIT Exon9 501-600 bases
Seq.
Primer Sequence
ID 015 Left TCCTCCTCTATGCTATTTCTTTTCA
3001 Left CCTCTATGCTATTTCTTTTCAACCA 016 Right TATGGTAGACAGAGCCTAAACATCC
3002 Right TATGGTAGACAGAGCCTAAACATCC
017 Left ATTTTATTGAATTCCTTTCCAATCC
3003 Left CTCACTAGGTCACCAAAGTGCTTAT 018 Right GTGATGCATGTATTACCAGAAATGA
3004 Right AGGCAGTGTTAACTTTTGGATACAG
Seq. 019 Left CTCACTAGGTCACCAAAGTGCTTAT
Primer Sequence
ID 020 Right GTAAATATATTCCCCCATTTGCTTT
3005 Left TTTTATGCTTTCCTCCTCTATGCTA
3006 Right CCCCTTAAATTGGATTAAAAAGAAA 021 Left GCTTTCCTCCTCTATGCTATTTCTT
022 Right AACATCCCCTTAAATTGGATTAAAA
3007 Left CTCACTAGGTCACCAAAGTGCTTAT
3008 Right GGCAGTGTTAACTTTTGGATACAGT 023 Left TTTTATGCTTTCCTCCTCTATGCTA
024 Right AACATCCCCTTAAATTGGATTAAAA
3009 Left GCTTTCCTCCTCTATGCTATTTCTT
3010 Right TATGGTAGACAGAGCCTAAACATCC 025 Left CCACATCCCAAGTGTTTTATGTATT
026 Right GGCAGTGTTAACTTTTGGATACAGT
3011 Left TTTTATGCTTTCCTCCTCTATGCTA
3012 Right TATGGTAGACAGAGCCTAAACATCC 027 Left TTTAGTAGAGACGAGGTTTCACCAT
028 Right CCCCTTAAATTGGATTAAAAAGAAA
3013 Left CCACATCCCAAGTGTTTTATGTATT
3014 Right AGGCAGTGTTAACTTTTGGATACAG 029 Left GCTGAGATTACAGGTGTGAGCTACT
3030 Right CCCCTTAAATTGGATTAAAAAGAAA 035 Left GCTGAGATTACAGGTGTGAGCTACT
036 Right TATGGTAGACAGAGCCTAAACATCC
3031 Left CTCACTAGGTCACCAAAGTGCTTAT
3032 Right GATTGTTCTAATTCTGTTTGGGTGT 037 Left CACTAGGTCACCAAAGTGCTTATTC
038 Right AGGCAGTGTTAACTTTTGGATACAG
3033 Left TACAGTCGTAGAAACTCAGTGTTGG
3034 Right GTAAATATATTCCCCCATTTGCTTT 039 Left TCACTAGGTCACCAAAGTGCTTATT
040 Right AGGCAGTGTTAACTTTTGGATACAG
KIT Exon9 801-1000 bases
Seq.
Primer Sequence
ID 061 Left CCCTGTTTTACAGTCGTAGAAACTC
3041 Left ATTCCTTTCCAATCCTTTCAGTAAC 062 Right AGGCAGTGTTAACTTTTGGATACAG
3042 Right AGGCAGTGTTAACTTTTGGATACAG
063 Left ATTCCTTTCCAATCCTTTCAGTAAC
3043 Left ATTTTATTGAATTCCTTTCCAATCC 064 Right GTAAATATATTCCCCCATTTGCTTT
3044 Right AGGCAGTGTTAACTTTTGGATACAG
065 Left TACATCCTTGATTTTGTTGTTGTTG
3045 Left TACAGTCGTAGAAACTCAGTGTTGG 066 Right AACATCCCCTTAAATTGGATTAAAA
3046 Right AGGCAGTGTTAACTTTTGGATACAG
067 Left AACCCTCTGCAATGGGTATTACTAT
3047 Left TACATCCTTGATTTTGTTGTTGTTG 068 Right AGGCAGTGTTAACTTTTGGATACAG
3048 Right CCCCTTAAATTGGATTAAAAAGAAA
069 Left TTATTGAATTCCTTTCCAATCCTTT
3049 Left ATTCCTTTCCAATCCTTTCAGTAAC 070 Right AGGCAGTGTTAACTTTTGGATACAG
3050 Right GGCAGTGTTAACTTTTGGATACAGT
071 Left TTTTATTGAATTCCTTTCCAATCCT
3051 Left CCTCTATGCTATTTCTTTTCAACCA 072 Right AGGCAGTGTTAACTTTTGGATACAG
3052 Right GTAAATATATTCCCCCATTTGCTTT
073 Left TTTATTGAATTCCTTTCCAATCCTT
3053 Left ATTTTATTGAATTCCTTTCCAATCC 074 Right AGGCAGTGTTAACTTTTGGATACAG
3054 Right GGCAGTGTTAACTTTTGGATACAGT
075 Left ATTTTATTGAATTCCTTTCCAATCC
3055 Left TTCTGGTCTACATCCTTGATTTTGT 076 Right GTAAATATATTCCCCCATTTGCTTT
3056 Right CCCCTTAAATTGGATTAAAAAGAAA
077 Left CCTCTATGCTATTTCTTTTCAACCA
3057 Left TACAGTCGTAGAAACTCAGTGTTGG 078 Right TGCTTTCTCTAGCTCTTTTTAATGG
3058 Right GGCAGTGTTAACTTTTGGATACAGT
Seq. 079 Left CCACATCCCAAGTGTTTTATGTATT
Primer Sequence
ID 080 Right ACTACTCAAAACCTGAGAAAACACG
3059 Left CCTCTATGCTATTTCTTTTCAACCA
3060 Right GATTGTTCTAATTCTGTTTGGGTGT
KIT Exon9 2kb
Seq.
Primer Sequence
ID 087 Left TGTAGGTGTTAAGAAAGGAAACAGG
3081 Left TGTAGGTGTTAAGAAAGGAAACAGG 088 Right ACTACTCAAAACCTGAGAAAACACG
3082 Right GCTTCCTTTATGGACGGTTTATATT
089 Left AAGTAATGATCGCACAATTACAACA
3083 Left TCCTCACTTTGACTATTTTCTGGTC 090 Right CCCCTTAAATTGGATTAAAAAGAAA
3084 Right GCTTCCTTTATGGACGGTTTATATT
091 Left CCAAGTTACCAAAAAGTAATGATCG
3085 Left GTTAAGAAAGGAAACAGGGAATAGC 092 Right CCCCTTAAATTGGATTAAAAAGAAA
3086 Right GCTTCCTTTATGGACGGTTTATATT
3093 Left TGGATAAGCTTGTTCTAGTGGGTAG
3094 Right ACTACTCAAAACCTGAGAAAACACG 107 Left GGTCTACATCCTTGATTTTGTTGTT
108 Right GCTTCCTTTATGGACGGTTTATATT
3095 Left TGTAGGTGTTAAGAAAGGAAACAGG
3096 Right CCTCACTACTCAAAACCTGAGAAAA 109 Left GGAATAAGCCTCTTTATCACAACAA
110 Right GTAAATATATTCCCCCATTTGCTTT
3097 Left ATAACTAGGCCTTCCTGCTTAGAAC
3098 Right GCTTCCTTTATGGACGGTTTATATT 111 Left TGTAGGTGTTAAGAAAGGAAACAGG
112 Right TCTTTAAGCTTTCCTGTATTTTCCA
3099 Left GTTAAGAAAGGAAACAGGGAATAGC
3100 Right CCTCACTACTCAAAACCTGAGAAAA 113 Left AAGTAATGATCGCACAATTACAACA
114 Right AACATCCCCTTAAATTGGATTAAAA
Seq.
Primer Sequence
ID 115 Left TAACTAGGCCTTCCTGCTTAGAACT
3101 Left TGGATAAGCTTGTTCTAGTGGGTAG 116 Right GCTTCCTTTATGGACGGTTTATATT
3102 Right CCTCACTACTCAAAACCTGAGAAAA
117 Left TTCATGGAATAAGCCTCTTTATCAC
3103 Left TCTGGTCTACATCCTTGATTTTGTT 118 Right GTAAATATATTCCCCCATTTGCTTT
3104 Right GCTTCCTTTATGGACGGTTTATATT
119 Left TTCTTTTGGGGAATACTAAGTAGGG
3105 Left TTCTGGTCTACATCCTTGATTTTGT 120 Right GTAAATATATTCCCCCATTTGCTTT
3106 Right GCTTCCTTTATGGACGGTTTATATT
JOT Exon9-10 2kb
Seq. 139 Left AACCCTCTGCAATGGGTATTACTAT
Primer Sequence
ID 140 Right ATTAGAGCACTCTGGAGAGAGAACA
3121 Left CCTCTATGCTATTTCTTTTCAACCA
3122 Right ATTAGAGCACTCTGGAGAGAGAACA 141 Left GCTGAGATTACAGGTGTGAGCTACT
142 Right ATTAGAGCACTCTGGAGAGAGAACA
3123 Left ATTCCTTTCCAATCCTTTCAGTAAC
3124 Right AGCACTCTGGAGAGAGAACAAATAA 143 Left ATTTTATTGAATTCCTTTCCAATCC
144 Right CTCTGGAGAGAGAACAAATAAATGG
3125 Left ATTCCTTTCCAATCCTTTCAGTAAC
3126 Right ATTAGAGCACTCTGGAGAGAGAACA 145 Left TTATTGAATTCCTTTCCAATCCTTT
146 Right ATTAGAGCACTCTGGAGAGAGAACA
3127 Left ATTTTATTGAATTCCTTTCCAATCC
3128 Right ATTAGAGCACTCTGGAGAGAGAACA 147 Left TTTATTGAATTCCTTTCCAATCCTT
148 Right ATTAGAGCACTCTGGAGAGAGAACA
3129 Left GCTTTCCTCCTCTATGCTATTTCTT
3130 Right ATTAGAGCACTCTGGAGAGAGAACA 149 Left TTTTATTGAATTCCTTTCCAATCCT
Seq. 150 Right ATTAGAGCACTCTGGAGAGAGAACA
Primer Sequence
ID
3131 Left AACCCTCTGCAATGGGTATTACTAT 151 Left ATGCTTTCCTCCTCTATGCTATTTC
3132 Right AGCACTCTGGAGAGAGAACAAATAA 152 Right AGCACTCTGGAGAGAGAACAAATAA
3133 Left GCTGAGATTACAGGTGTGAGCTACT 153 Left TTTTATGCTTTCCTCCTCTATGCTA
3134 Right AGCACTCTGGAGAGAGAACAAATAA 154 Right CTCTGGAGAGAGAACAAATAAATGG
3135 Left ATTCCTTTCCAATCCTTTCAGTAAC 155 Left ATGCTTTCCTCCTCTATGCTATTTC
3136 Right GCACTCTGGAGAGAGAACAAATAAA 156 Right ATTAGAGCACTCTGGAGAGAGAACA
3137 Left ATTCCTTTCCAATCCTTTCAGTAAC 157 Left ATTCCTTTCCAATCCTTTCAGTAAC
3138 Right CTCTGGAGAGAGAACAAATAAATGG 158 Right GAGCACTCTGGAGAGAGAACAAATA
3223 Left CACATTTCTCTTCCATTGT 233 Left CACATTTCTCTTCCATTGTA
3224 Right GAGAGAACAAATAAATGGTTAC 234 Right GAGAGAACAAATAAATGGTTA
3225 Left CCACATTTCTCTTCCATTGT 235 Left CCACATTTCTCTTCCATTGTA
3226 Right AGAGAACAAATAAATGGTTA 236 Right GAGAACAAATAAATGGTTA
3227 Left CCACATTTCTCTTCCATTGT 237 Left CACATTTCTCTTCCATTGTA
3228 Right GAGAACAAATAAATGGTTAC 238 Right AGAGAACAAATAAATGGTTAC
3229 Left CATTTCTCTTCCATTGTA 239 Left TCCACATTTCTCTTCCATTG
3230 Right GAGAGAGAACAAATAAATGGTTAC 240 Right GAGAACAAATAAATGGTTA
3231 Left ACATTTCTCTTCCATTGTA
3232 Right AGAGAGAACAAATAAATGGTTAC
KIT ΈχοηΙΟ 151-200 bases
Seq.
Primer Sequence
ID 3 261 Left AAAGTTTGTGATTCCACATTTCTCT
3241 Left AGTTTGTGATTCCACATTTCTCTTC J 262 Right GAGCACTCTGGAGAGAGAACAAATA
3242 Right AGCACTCTGGAGAGAGAACAAATAA
3 263 Left CAAAGTTTGTGATTCCACATTTCTC
3243 Left AGTTTGTGATTCCACATTTCTCTTC J 264 Right AGCACTCTGGAGAGAGAACAAATAA
3244 Right GCACTCTGGAGAGAGAACAAATAAA
3 265 Left CAAAGTTTGTGATTCCACATTTCTC
3245 Left AGTTTGTGATTCCACATTTCTCTTC J 266 Right GCACTCTGGAGAGAGAACAAATAAA
3246 Right GAGCACTCTGGAGAGAGAACAAATA
1 267 Left CAAAGTTTGTGATTCCACATTTCTC
3247 Left AGTTTGTGATTCCACATTTCTCTTC 3 268 Right CTCTGGAGAGAGAACAAATAAATGG
3248 Right TCTGGAGAGAGAACAAATAAATGGT
1 269 Left AGTTTGTGATTCCACATTTCTCTTC
3249 Left AAGTTTGTGATTCCACATTTCTCTT J 270 Right CTCTGGAGAGAGAACAAATAAATGGT
3250 Right AGCACTCTGGAGAGAGAACAAATAA
1 271 Left CAAAGTTTGTGATTCCACATTTCTC
3251 Left AAAGTTTGTGATTCCACATTTCTCT J 272 Right GAGCACTCTGGAGAGAGAACAAATA
3252 Right AGCACTCTGGAGAGAGAACAAATAA
1 273 Left CAAAGTTTGTGATTCCACATTTCTC
3253 Left GATTCCACATTTCTCTTCCATTGTA J 274 Right TCTGGAGAGAGAACAAATAAATGGT
3254 Right AGCACTCTGGAGAGAGAACAAATAA
3 275 Left CAAAGTTTGTGATTCCACATTTCT
3255 Left AAGTTTGTGATTCCACATTTCTCTT J 276 Right AGCACTCTGGAGAGAGAACAAATAA
3256 Right GCACTCTGGAGAGAGAACAAATAAA
Seq. 3 277 Left GTGATTCCACATTTCTCTTCCATT
Primer Sequence
ID 3 278 Right AGCACTCTGGAGAGAGAACAAATAA
3257 Left AAAGTTTGTGATTCCACATTTCTCT
3258 Right GCACTCTGGAGAGAGAACAAATAAA 3 279 Left CAAAGTTTGTGATTCCACATTTCT
3 280 Right ATTAGAGCACTCTGGAGAGAGAACA
3259 Left AAGTTTGTGATTCCACATTTCTCTT
3260 Right GAGCACTCTGGAGAGAGAACAAATA
KIT ΈχοηΙΟ 201-300 bases
Seq. 3 282 Right AGCACTCTGGAGAGAGAACAAATAA
Primer Sequence
ID
3281 Left GTACAATGTAACCAAGGTGAAGCTC 1 283 Left GAGTACAATGTAACCAAGGTGAAGC
3284 Right AGCACTCTGGAGAGAGAACAAATAA 3302 Right GAGCACTCTGGAGAGAGAACAAATA
3285 Left TACAATGTAACCAAGGTGAAGCTCT 3 303 Left GAGTACAATGTAACCAAGGTGAAGC
3286 Right AGCACTCTGGAGAGAGAACAAATAA 3 304 Right GAGCACTCTGGAGAGAGAACAAATA
3287 Left TACAATGTAACCAAGGTGAAGCTCT 3 305 Left GTACAATGTAACCAAGGTGAAGCTC
3288 Right ATTAGAGCACTCTGGAGAGAGAACA 3 306 Right TCTGGAGAGAGAACAAATAAATGGT
3289 Left GTACAATGTAACCAAGGTGAAGCTC 3 307 Left GAGTACAATGTAACCAAGGTGAAGC
3290 Right GCACTCTGGAGAGAGAACAAATAAA 3 308 Right TCTGGAGAGAGAACAAATAAATGGT
3291 Left GAGTACAATGTAACCAAGGTGAAGC 3 309 Left TACAATGTAACCAAGGTGAAGCTCT
3292 Right GCACTCTGGAGAGAGAACAAATAAA 3 310 Right GAGCACTCTGGAGAGAGAACAAATA
3293 Left GTACAATGTAACCAAGGTGAAGCTC 3 311 Left TACAATGTAACCAAGGTGAAGCTCT
3294 Right CTCTGGAGAGAGAACAAATAAATGG 3 312 Right TCTGGAGAGAGAACAAATAAATGGT
3295 Left GAGTACAATGTAACCAAGGTGAAGC 3 313 Left CTCTGAGACTCACATAGCTTTGCAT
3296 Right CTCTGGAGAGAGAACAAATAAATGG 3 314 Right AGCACTCTGGAGAGAGAACAAATAA
3297 Left TACAATGTAACCAAGGTGAAGCTCT 3 315 Left GTACAATGTAACCAAGGTGAAGCTC
3298 Right GCACTCTGGAGAGAGAACAAATAAA 3 316 Right TAGAGCACTCTGGAGAGAGAACAAA
3299 Left TACAATGTAACCAAGGTGAAGCTCT 3 317 Left CTCTGAGACTCACATAGCTTTGCAT
3300 Right CTCTGGAGAGAGAACAAATAAATGG 3 318 Right ATTAGAGCACTCTGGAGAGAGAACA
Seq. 3 319 Left TACAATGTAACCAAGGTGAAGCTC
Primer Sequence
ID 3 320 Right AGCACTCTGGAGAGAGAACAAATAA
3301 Left GTACAATGTAACCAAGGTGAAGCTC
KIT ΈχοηΙΟ 301-400 bases
Seq.
Primer Sequence
ID 335 Left TCTGCAGTATTGTGGTTTCAAGTTA
3321 Left TCTATTCTGCAGTATTGTGGTTTCA r. 336 Right GCACTCTGGAGAGAGAACAAATAAA
3322 Right AGCACTCTGGAGAGAGAACAAATAA
337 Left TATTCTGCAGTATTGTGGTTTCAAG
3323 Left TCTGCAGTATTGTGGTTTCAAGTTA 338 Right AGCACTCTGGAGAGAGAACAAATAA
3324 Right AGCACTCTGGAGAGAGAACAAATAA
339 Left CTATTCTGCAGTATTGTGGTTTCAA
3325 Left TCTATTCTGCAGTATTGTGGTTTCA 340 Right AGCACTCTGGAGAGAGAACAAATAA
3326 Right ATTAGAGCACTCTGGAGAGAGAACA
341 Left TCTGCAGTATTGTGGTTTCAAGTTA
3327 Left TCTGCAGTATTGTGGTTTCAAGTTA 342 Right CTCTGGAGAGAGAACAAATAAATGG
3328 Right ATTAGAGCACTCTGGAGAGAGAACA
Seq. 343 Left GAGTACAATGTAACCAAGGTGAAGC
Primer Sequence
ID -. 344 Right ATTAGAGCACTCTGGAGAGAGAACA
3329 Left TCTATTCTGCAGTATTGTGGTTTCA
3330 Right GCACTCTGGAGAGAGAACAAATAAA 345 Left GTACAATGTAACCAAGGTGAAGCTC
346 Right ATTAGAGCACTCTGGAGAGAGAACA
3331 Left ATTCTGCAGTATTGTGGTTTCAAGT
3332 Right AGCACTCTGGAGAGAGAACAAATAA 347 Left ATTCTGCAGTATTGTGGTTTCAAGT
348 Right ATTAGAGCACTCTGGAGAGAGAACA
3333 Left TCTATTCTGCAGTATTGTGGTTTCA
g t g t
JOT Exonll 201-300 bases
Seq. 405 Left GTTCTCTCTCCAGAGTGCTCTAATG
Primer Sequence
ID 406 Right TTATGTGTACCCAAAAAGGTGACAT
3401 Left TTATTTGTTCTCTCTCCAGAGTGCT
3402 Right TTATGTGTACCCAAAAAGGTGACAT 407 Left CAGAGTGCTCTAATGACTGAGACAA
408 Right TTATGTGTACCCAAAAAGGTGACAT
3403 Left TGTTCTCTCTCCAGAGTGCTCTAAT
3404 Right TTATGTGTACCCAAAAAGGTGACAT 409 Left CTCTCTCCAGAGTGCTCTAATGACT
410 Right TTATGTGTACCCAAAAAGGTGACAT
425 Left GTTCTCTCTCCAGAGTGCTCTAATG
341 1 Left TTATTTGTTCTCTCTCCAGAGTGCT 426 Right TGTTATGTGTACCCAAAAAGGTGAC
3412 Right TGTTATGTGTACCCAAAAAGGTGAC
427 Left TGTTCTCTCTCCAGAGTGCTCTAAT
3413 Left TTATTTGTTCTCTCTCCAGAGTGCT 428 Right GTTATGTGTACCCAAAAAGGTGACA
3414 Right GTTATGTGTACCCAAAAAGGTGACA
429 Left GTTCTCTCTCCAGAGTGCTCTAATG
3415 Left AAGGTGATCTATTTTTCCCTTTCTC 430 Right GTTATGTGTACCCAAAAAGGTGACA
3416 Right TTATGTGTACCCAAAAAGGTGACAT
431 Left GTTCTCTCTCCAGAGTGCTCTAATG
3417 Left AAGGTGATCTATTTTTCCCTTTCTC 432 Right CTGTTATGTGTACCCAAAAAGGTG
3418 Right GCAATTTCACAGAAAACTCATTGTT
433 Left TGTTCTCTCTCCAGAGTGCTCTAAT
3419 Left TTATTTGTTCTCTCTCCAGAGTGCT 434 Right CTGTTATGTGTACCCAAAAAGGTG
3420 Right CTGTTATGTGTACCCAAAAAGGTG
435 Left CAGAGTGCTCTAATGACTGAGACAA
Seq. 436 Right GTTATGTGTACCCAAAAAGGTGACA
Primer Sequence
ID
3421 Left TCTCTCTCCAGAGTGCTCTAATGAC 437 Left CAGAGTGCTCTAATGACTGAGACAA
3422 Right TTATGTGTACCCAAAAAGGTGACAT 438 Right TGTTATGTGTACCCAAAAAGGTGAC
3423 Left TGTTCTCTCTCCAGAGTGCTCTAAT 439 Left TTATTTGTTCTCTCTCCAGAGTGCT
3424 Right TGTTATGTGTACCCAAAAAGGTGAC 440 Right CTGTTATGTGTACCCAAAAAGGTGA
KIT Έχοηΐΐ 301-400 bases
Seq. 455 Left CAGAGTGCTCTAATGACTGAGACAA
Primer Sequence
ID : 456 Right GTTCTCTATGGCAAACCTATCAAAA
3441 Left TTATTTGTTCTCTCTCCAGAGTGCT
3442 Right TTCTCTATGGCAAACCTATCAAAAG 457 Left TTATTTGTTCTCTCTCCAGAGTGCT
458 Right ATGTTGTCCAGAGACATTTTCCTAC
3443 Left TTATTTGTTCTCTCTCCAGAGTGCT
3444 Right GTTCTCTATGGCAAACCTATCAAAA J 459 Left TGTTCTCTCTCCAGAGTGCTCTAAT
460 Right ATGTTGTCCAGAGACATTTTCCTAC
3445 Left TGTTCTCTCTCCAGAGTGCTCTAAT
3446 Right TTCTCTATGGCAAACCTATCAAAAG
3447 Left GTTCTCTCTCCAGAGTGCTCTAATG 461 Left GTTCTCTCTCCAGAGTGCTCTAATG
3448 Right TTCTCTATGGCAAACCTATCAAAAG 462 Right ATGTTGTCCAGAGACATTTTCCTAC
3449 Left CAGAGTGCTCTAATGACTGAGACAA 463 Left TTATTTGTTCTCTCTCCAGAGTGCT
3450 Right TTCTCTATGGCAAACCTATCAAAAG 464 Right CATTTTCCTACGATGTTCTCTATGG
3465 Left CTCTCTCCAGAGTGCTCTAATGACT
3466 Right TTCTCTATGGCAAACCTATCAAAAG
Seq.
Primer Sequence
ID 467 Left TTATTTGTTCTCTCTCCAGAGTGCT
3451 Left GTTCTCTCTCCAGAGTGCTCTAATG 468 Right ATGTTCTCTATGGCAAACCTATCAA
3452 Right GTTCTCTATGGCAAACCTATCAAAA
469 Left CAGAGTGCTCTAATGACTGAGACAA
3453 Left TGTTCTCTCTCCAGAGTGCTCTAAT 470 Right ATGTTGTCCAGAGACATTTTCCTAC
3454 Right GTTCTCTATGGCAAACCTATCAAAA
3535 Left ACTTACCTTGTTGTCTTCCTTCCTA
3536 Right CATGCAGTACCATACAGGAACTTAC : 549 Left CATCACCACTTACCTTGTTGTCTT
: 550 Right CATGCAGTACCATACAGGAACTTAC
3537 Left CATCACCACTTACCTTGTTGTCTTC
3538 Right CATGCAGTACCATACAGGAACTTAC : 551 Left ACCTTGTTGTCTTCCTTCCTACAG
: 552 Right GCATGCAGTACCATACAGGAACTTA
3539 Left CACTTACCTTGTTGTCTTCCTTCCT
3540 Right CATGCAGTACCATACAGGAACTTAC : 553 Left ACCACTTACCTTGTTGTCTTCCTTC
: 554 Right GCATGCAGTACCATACAGGAACTTA
3541 Left CCACTTACCTTGTTGTCTTCCTTC
3542 Right CATGCAGTACCATACAGGAACTTAC : 555 Left TACCTTGTTGTCTTCCTTCCTACA
: 556 Right CATGCAGTACCATACAGGAACTTAC
3543 Left CACTTACCTTGTTGTCTTCCTTCC
3544 Right CATGCAGTACCATACAGGAACTTAC : 557 Left CTTACCTTGTTGTCTTCCTTCCTAC
558 Right GCATGCAGTACCATACAGGAACTTA
3545 Left ACTTACCTTGTTGTCTTCCTTCCTAC
3546 Right CATGCAGTACCATACAGGAACTTAC : 559 Left ACTTACCTTGTTGTCTTCCTTCCTA
: 560 Right GCATGCAGTACCATACAGGAACTTA
3547 Left ACCACTTACCTTGTTGTCTTCCTT
KIT ExonU 201-300 bases
Seq.
Primer Sequence
ID 581 Left GCCATAGAGAACATCGTAGGAAAAT
3561 Left CTTTTGATAGGTTTGCCATAGAGAA 582 Right CATGCAGTACCATACAGGAACTTAC
3562 Right CATGCAGTACCATACAGGAACTTAC
583 Left TTGATAGGTTTGCCATAGAGAACA
3563 Left AGAACATCGTAGGAAAATGTCTCTG 584 Right CATGCAGTACCATACAGGAACTTAC
3564 Right CATGCAGTACCATACAGGAACTTAC
585 Left AATTCCTTTATTGATTTTGAAACTGC
3565 Left CCATAGAGAACATCGTAGGAAAATG 586 Right CATGCAGTACCATACAGGAACTTAC
3566 Right CATGCAGTACCATACAGGAACTTAC
587 Left TTTGATAGGTTTGCCATAGAGAACA
3567 Left CTTTTGATAGGTTTGCCATAGAGAA 588 Right CATGCAGTACCATACAGGAACTTAC
3568 Right GCATGCAGTACCATACAGGAACTTA
589 Left TCTCTGGACAACATTGTTTTTAATTC
3569 Left TCCTTTATTGATTTTGAAACTGCAC 590 Right CATGCAGTACCATACAGGAACTTAC
3570 Right CATGCAGTACCATACAGGAACTTAC
591 Left TAGGTTTGCCATAGAGAACATCGTA
3571 Left TGATAGGTTTGCCATAGAGAACATC 592 Right CATGCAGTACCATACAGGAACTTAC
3572 Right CATGCAGTACCATACAGGAACTTAC
593 Left TGTCTCTGGACAACATTGTTTTTAAT
3573 Left AGAACATCGTAGGAAAATGTCTCTG 594 Right CATGCAGTACCATACAGGAACTTAC
3574 Right GCATGCAGTACCATACAGGAACTTA
595 Left AATGTCTCTGGACAACATTGTTTTTA
3575 Left CCATAGAGAACATCGTAGGAAAATG 596 Right CATGCAGTACCATACAGGAACTTAC
3576 Right GCATGCAGTACCATACAGGAACTTA
Seq. 597 Left TGGACAACATTGTTTTTAATTCCTT
Primer Sequence
ID 598 Right GCATTTTAGCAAAAAGCACAACT
3577 Left ATTCCTTTATTGATTTTGAAACTGC
3578 Right CATGCAGTACCATACAGGAACTTAC 599 Left TCCTTTATTGATTTTGAAACTGCAC
600 Right GCATGCAGTACCATACAGGAACTTA
3579 Left ATGTCTCTGGACAACATTGTTTTTA
3660 Right GCTTGGACACGGCTTTAC
671 Left ATGCATGTTTCCAATTTT
3661 Left TGCATGTTTCCAATTTTA 672 Right AGCTTGGACACGGCTTTAC
3662 Right CAGCTTGGACACGGCTTTA
673 Left GCATGTTTCCAATTTTAG
3663 Left ATGCATGTTTCCAATTTTA 674 Right CAGCTTGGACACGGCTTTAC
3664 Right AGCTTGGACACGGCTTTAC
675 Left TGCATGTTTCCAATTTTAG
3665 Left AATGCATGTTTCCAATTTT 676 Right GCTTGGACACGGCTTTAC
3666 Right GCTTGGACACGGCTTTAC
677 Left GCATGTTTCCAATTTTAG
3667 Left TGCATGTTTCCAATTTTA 678 Right CAGCTTGGACACGGCTTTA
3668 Right CAGCTTGGACACGGCTTT
679 Left TGCATGTTTCCAATTTTA
3669 Left TGCATGTTTCCAATTTTAG 680 Right AGCTTGGACACGGCTTTAC
JOT Exonl3 151-200 bases
Seq.
Primer Sequence
ID 3 701 Left TGCTAAAATGCATGTTTCCAAT
3681 Left TGCTAAAATGCATGTTTCCAAT J 702 Right TGTTTTGATAACCTGACAGACAATAA
3682 Right CATGTTTTGATAACCTGACAGACAA
1 703 Left TAAAATGCATGTTTCCAATTTTAG
3683 Left TAAAATGCATGTTTCCAATTTTAG 3 704 Right ATGTTTTGATAACCTGACAGACAAT
3684 Right CATGTTTTGATAACCTGACAGACAA
1 705 Left TGCTAAAATGCATGTTTCCAAT
3685 Left TGCTAAAATGCATGTTTCCAAT 3 706 Right CATGTTTTGATAACCTGACAGACA
3686 Right TTGATAACCTGACAGACAATAAAAG(
1 707 Left TAAAATGCATGTTTCCAATTTTAG
3687 Left TAAAATGCATGTTTCCAATTTTAG J 708 Right TGTTTTGATAACCTGACAGACAATAA
3688 Right TTGATAACCTGACAGACAATAAAAG(
1 709 Left TAAAATGCATGTTTCCAATTTTAG
3689 Left TGCTAAAATGCATGTTTCCAAT J 710 Right CATGTTTTGATAACCTGACAGACA
3690 Right TGATAACCTGACAGACAATAAAAGG
1 711 Left TGCTAAAATGCATGTTTCCAAT
3691 Left TAAAATGCATGTTTCCAATTTTAG J 712 Right CTGACAGACAATAAAAGGCAGCTT
3692 Right TGATAACCTGACAGACAATAAAAGG
3 713 Left TAAAATGCATGTTTCCAATTTTAG
3693 Left AAAATGCATGTTTCCAATTTTAG J 714 Right CTGACAGACAATAAAAGGCAGCTT
3694 Right CATGTTTTGATAACCTGACAGACAA
1 715 Left TGCTAAAATGCATGTTTCCAAT
3695 Left TGCTAAAATGCATGTTTCCAAT 3 716 Right TGTTTTGATAACCTGACAGACAATA
3696 Right CATGTTTTGATAACCTGACAGACAAT
3697 Left TAAAATGCATGTTTCCAATTTTAG
3698 Right CATGTTTTGATAACCTGACAGACAAT 3 717 Left TAAAATGCATGTTTCCAATTTTAG
3718 Right TGTTTTGATAACCTGACAGACAATA
Seq. 3 719 Left AAAATGCATGTTTCCAATTTTAG
Primer Sequence
ID 3 720 Right TTGATAACCTGACAGACAATAAAAGG
3699 Left TGCTAAAATGCATGTTTCCAAT
4285 Left GTTTTCTTTTCTCCTCCAACCTAAT
4286 Right TGTGTGATATCCCTAGACAGGATTT 303 Left TTTTCTTTTCTCCTCCAACCTAATA
304 Right TGTGTGATATCCCTAGACAGGATTT
4287 Left GTTTTCTTTTCTCCTCCAACCTAAT
4288 Right CACAGGAAACAATTTTTATCGAAAG 305 Left TGAATTTAAATGGTTTTCTTTTCTCC
4306 Right CACAGGAAACAATTTTTATCGAAAG
307 Left TGAATTTAAATGGTTTTCTTTTCTCC
4289 Left GTTTTCTTTTCTCCTCCAACCTAAT 308 Right AAAATGTGTGATATCCCTAGACAGG
4290 Right AAAATGTGTGATATCCCTAGACAGG
309 Left TTTTCTTTTCTCCTCCAACCTAATA
4291 Left TGAATTTAAATGGTTTTCTTTTCTCC 310 Right CACAGGAAACAATTTTTATCGAAAG
4292 Right TGTGTGATATCCCTAGACAGGATTT
311 Left TAAATGGTTTTCTTTTCTCCTCCA
4293 Left TGAATTTAAATGGTTTTCTTTTCTCC 312 Right ATCACAGGAAACAATTTTTATCGAA
4294 Right AAATGTGTGATATCCCTAGACAGGA
313 Left TAAATGGTTTTCTTTTCTCCTCCA
4295 Left TTTTCTTTTCTCCTCCAACCTAATA 314 Right AAATGTGTGATATCCCTAGACAGGA
4296 Right ATCACAGGAAACAATTTTTATCGAA
315 Left TAAATGGTTTTCTTTTCTCCTCCA
4297 Left GTTTTCTTTTCTCCTCCAACCTAAT 316 Right TGTGTGATATCCCTAGACAGGATTT
4298 Right ATGTGTGATATCCCTAGACAGGATT
317 Left TTTTCTTTTCTCCTCCAACCTAATA
4299 Left GTTTTCTTTTCTCCTCCAACCTAAT 318 Right AAAATGTGTGATATCCCTAGACAGG
4300 Right AATGTGTGATATCCCTAGACAGGAT
319 Left TAAATGGTTTTCTTTTCTCCTCCAA
4301 Left TTTTCTTTTCTCCTCCAACCTAATA 320 Right ATCACAGGAAACAATTTTTATCGAA
KIT Exonll 301-400
Seq. 335 Left TTCAAGGCGTACTTTTGATTTTTAT
Primer Sequence
ID 336 Right TCGAAAGTTGAAACTAAAAATCCTTT
4321 Left ATTCAAGGCGTACTTTTGATTTTTA
4322 Right ATCACAGGAAACAATTTTTATCGAA 337 Left ATTCAAGGCGTACTTTTGATTTTTA
338 Right TCACAGGAAACAATTTTTATCGAA
4323 Left TCAAGGCGTACTTTTGATTTTTATT 5eq.
Primer Sequence
4324 Right ATCACAGGAAACAATTTTTATCGAA ID
339 Left TCAAGGCGTACTTTTGATTTTTATT
4325 Left TTCAAGGCGTACTTTTGATTTTTAT 340 Right TCACAGGAAACAATTTTTATCGAA
4326 Right ATCACAGGAAACAATTTTTATCGAA
341 Left TTCAAGGCGTACTTTTGATTTTTAT
4327 Left ATTCAAGGCGTACTTTTGATTTTTA 342 Right TCACAGGAAACAATTTTTATCGAA
4328 Right CACAGGAAACAATTTTTATCGAAAG
343 Left ATTCAAGGCGTACTTTTGATTTTT
4329 Left GTTTTCTTTTCTCCTCCAACCTAAT 344 Right ATCACAGGAAACAATTTTTATCGAA
4330 Right TAGTAATGTTCAGCATACCATGCAA
345 Left TTCAAGGCGTACTTTTGATTTTTATT
4331 Left ATTCAAGGCGTACTTTTGATTTTTAT 346 Right ATCACAGGAAACAATTTTTATCGAA
4332 Right ATCACAGGAAACAATTTTTATCGAA
347 Left AGTCCTGAGAAGAAAACAGCATTTA
4333 Left ATCATTCAAGGCGTACTTTTGATTT 348 Right ACTGTCAAGCAGAGAATGGGTACT
4334 Right ATCACAGGAAACAATTTTTATCGAA
349 Left ATTCAAGGCGTACTTTTGATTTTT
4543 Left TATTTCCCTATGAATGAAAGCAGTC 552 Right GGCAGAGAATATTATAAAGGGCAAT
4544 Right AAAACCCACAATTACTTTTACACCA
553 Left AGAGCCATAGTTAAAATGCAGAATG
4545 Left AACCAAAAGCAGAGGAAATTTAGTT 554 Right GGCAGAGAATATTATAAAGGGCAAT
4546 Right ATTACATTATCATAAGGGGCACAAA
555 Left AGCCATAGTTAAAATGCAGAATGTC
4547 Left GAAGGTTAGGAATGGAAAGAATGAT 556 Right ATTACATTATCATAAGGGGCACAAA
4548 Right ATTCAGAGGTATTGGACAACTCTTG
557 Left GAGCCATAGTTAAAATGCAGAATGT
4549 Left AGCCATAGTTAAAATGCAGAATGTC 558 Right ATTACATTATCATAAGGGGCACAAA
4550 Right GGCAGAGAATATTATAAAGGGCAAT
559 Left AGAGCCATAGTTAAAATGCAGAATG
4551 Left GAGCCATAGTTAAAATGCAGAATGT 560 Right ATTACATTATCATAAGGGGCACAAA
JOT Exonl7 5kb
Seq. 5eq.
Primer Sequence Primer Sequence
ID ID
4561 Left ATGGTTCAGAAAATCATCCAAATTA 581 Left GTACCTACCTATCAAGCAACCAAGA
4562 Right TCTGCCATAAAAAGCTAAATCAATC 582 Right GGCCACTAAGTTGTAAGTGCTGTAT
4563 Left TCAGAAAATCATCCAAATTATTGGT 583 Left GAGTACCTACCTATCAAGCAACCAA
4564 Right TCTGCCATAAAAAGCTAAATCAATC 584 Right GGCCACTAAGTTGTAAGTGCTGTAT
4565 Left GTATATTGCTGCAGTTGTGTGGTAG 585 Left TCATGGTGTTTCTATGCTAATCAGA
4566 Right TAAGGGCTCCTAACCTGAGATCTAT 586 Right TAAGGGCTCCTAACCTGAGATCTAT
4567 Left TCATGGTGTTTCTATGCTAATCAGA 587 Left GTAACCCAGCCTAGGATTGTTAAAT
4568 Right TCTGCCATAAAAAGCTAAATCAATC 588 Right CTTGAGTACCATCTCACAAAAACCT
4569 Left GTACCTACCTATCAAGCAACCAAGA 589 Left TCATGGTGTTTCTATGCTAATCAGA
4570 Right CTTGAGTACCATCTCACAAAAACCT 590 Right GGCCACTAAGTTGTAAGTGCTGTAT
4571 Left GAGTACCTACCTATCAAGCAACCAA 591 Left AACCAAAAGCAGAGGAAATTTAGTT
4572 Right CTTGAGTACCATCTCACAAAAACCT 592 Right CAGTGTGTCATAAAGAATCCAAGTG
4573 Left TCTATGCTAATCAGAAGCAGGAAGT 593 Left TCTATGCTAATCAGAAGCAGGAAGT
4574 Right TCTGCCATAAAAAGCTAAATCAATC 594 Right TAAGGGCTCCTAACCTGAGATCTAT
4575 Left ATGGTTCAGAAAATCATCCAAATTA 595 Left ATGTTTTTGTGCCTGAGTATCTTTC
4576 Right GGCCACTAAGTTGTAAGTGCTGTAT 596 Right CAGTGTGTCATAAAGAATCCAAGTG
4577 Left TCAGAAAATCATCCAAATTATTGGT 597 Left TCTATGCTAATCAGAAGCAGGAAGT
4578 Right GGCCACTAAGTTGTAAGTGCTGTAT 598 Right GGCCACTAAGTTGTAAGTGCTGTAT
4579 Left GTATATTGCTGCAGTTGTGTGGTAG 599 Left AACCAAAAGCAGAGGAAATTTAGTT
4580 Right AAAACCCACAATTACTTTTACACCA 600 Right CAATTTGCAACCTAAGATTAGGAGA
Table 10. KRAS Capture Primer List for NGS Panel
KRAS Exonl 169-300 bases
Seq. 601 Left CTCGGAGCTCGATTTTCCTA
Primer Sequence
4794 Right TAACCTCAAACAGTGGTCTCTAAGC 798 Right ACACAATAACCTCAAACAGTGGTCT
4795 Left CCCGTCTGAAGAAGAATCGAG 799 Left CCCGTCTGAAGAAGAATCGAG
4796 Right ACAGTGGTCTCTAAGCACTTTCCTA 800 Right AAACACAATAACCTCAAACAGTGGT
ERAS Exonl 2kb
Seq.
Primer Sequence
ID 821 Left GGGATTTAAATTCAGCTTTATTGGT
4801 Left GGGATTTAAATTCAGCTTTATTGGT 822 Right TAACCTCAAACAGTGGTCTCTAAGC
4802 Right ACAGTGGTCTCTAAGCACTTTCCTA
Seq. 823 Left TCAAGACTCTCCCAAGATACATTTC
Primer Sequence
ID 824 Right ATAAGAAATAGGGGAAAGGACAAGA
4803 Left GGGATTTAAATTCAGCTTTATTGGT
4804 Right CATCTGGGATTAACTTTTTCCTTTT 825 Left TCAAGACTCTCCCAAGATACATTTC
4805 Left TCAAGACTCTCCCAAGATACATTTC 826 Right TAACCTCAAACAGTGGTCTCTAAGC
4806 Right TTTGCTATTGCTGTCTACACTCAAC
827 Left TTCAGCTTTATTGGTGGTTTATGAT
4807 Left TCAAGACTCTCCCAAGATACATTTC 828 Right ACAGTGGTCTCTAAGCACTTTCCTA
4808 Right ACAGTGGTCTCTAAGCACTTTCCTA
829 Left ATTCAGCTTTATTGGTGGTTTATGA
4809 Left GGGATTTAAATTCAGCTTTATTGGT 830 Right ACAGTGGTCTCTAAGCACTTTCCTA
4810 Right AAACACAATAACCTCAAACAGTGGT
831 Left GGGATTTAAATTCAGCTTTATTGGT
4811 Left TCAAGACTCTCCCAAGATACATTTC 832 Right ACACAATAACCTCAAACAGTGGTCT
4812 Right CATCTGGGATTAACTTTTTCCTTTT
833 Left TTCAGCTTTATTGGTGGTTTATGAT
4813 Left TCAAGACTCTCCCAAGATACATTTC 834 Right CATCTGGGATTAACTTTTTCCTTTT
4814 Right AAACACAATAACCTCAAACAGTGGT
835 Left ATTCAGCTTTATTGGTGGTTTATGA
4815 Left GTAGAAAGGAAAGGATGACAGTTGA 836 Right CATCTGGGATTAACTTTTTCCTTTT
4816 Right AAACACAATAACCTCAAACAGTGGT
837 Left ATTCAGCTTTATTGGTGGTTTATGA
4817 Left GATTACAGCCCGTGTAAGAGTAGAA 838 Right AAACACAATAACCTCAAACAGTGGT
4818 Right ACAGTGGTCTCTAAGCACTTTCCTA
839 Left TTCAGCTTTATTGGTGGTTTATGAT
4819 Left GATTACAGCCCGTGTAAGAGTAGAA 840 Right AAACACAATAACCTCAAACAGTGGT
4820 Right AAACACAATAACCTCAAACAGTGGT
ERAS Exonl 5kb
Seq.
Primer Sequence
ID 849 Left TGCTTTGAATGTTAGTCACAGAGAG
4841 Left GGGATTTAAATTCAGCTTTATTGGT 850 Right TGATGGATCTCAAGATTTAAGAAGG
4842 Right CAAAGCAATTAGGAATAGATGAGGA
851 Left ACGTAAGTAAGGAAGGGAGAACAGT
4843 Left ACGTAAGTAAGGAAGGGAGAACAGT 852 Right AACAGTTCTCAAAATGTGGTCTAGG
4844 Right CAAAGCAATTAGGAATAGATGAGGA
853 Left ACGTAAGTAAGGAAGGGAGAACAGT
4845 Left AGCAGTAAATGAAACAGACCAAAAC 854 Right TCCTTTCCCTCATGTAACACATAAT
4846 Right CAAAGCAATTAGGAATAGATGAGGA
855 Left CGAATCATGAGCCTAGATGATAACT
4847 Left GGGATTTAAATTCAGCTTTATTGGT 856 Right ATCCAACAATTTTGTAATGGAAGAA
4974 Right CCAAGGAAAGTAAAGTTCCCATATT 4S 87 Left GGTACTGGTGGAGTATTTGATAGTGT
4988 Right CCAAGGAAAGTAAAGTTCCCATATT
5( 139 Left TGAAGTACAGTTCATTACGATACACG
5037 Left TGAAGTACAGTTCATTACGATACACC 5( 140 Right TGACATACTCCCAAGGAAAGTAAAG
5038 Right CTGACATACTCCCAAGGAAAGTAAA
ERAS Exon2 601-800 bases
Seq. 5( 159 Left AGTCATGATATGATCCTTTGAGAGC
Primer Sequence
ID 5( 160 Right GAAACCCAAGGTACATTTCAGATAA
5041 Left AGTCATGATATGATCCTTTGAGAGC
5042 Right CCAAGGAAAGTAAAGTTCCCATATT 5( 161 Left CTACTGCCATGATGCTTTAAAAGTT
5( 162 Right TAACTTGAAACCCAAGGTACATTTC
5043 Left AGTCATGATATGATCCTTTGAGAGC
5044 Right CGAAACTCTGAAATACACTTCCAAT 5( 163 Left AGAGCACTGTGAAGTCTCTACATGA
5064 Right CCAAGGAAAGTAAAGTTCCCATATT
Seq. 5( 165 Left AGTCATGATATGATCCTTTGAGAGC
Primer Sequence
ID 5( 166 Right TACAAATTTCTACCCTCTCACGAAA
5045 Left AGTCATGATATGATCCTTTGAGAGC
5046 Right TGACATACTCCCAAGGAAAGTAAAG 5( 167 Left AGTCATGATATGATCCTTTGAGAGC
5( 168 Right AAATTTCTACCCTCTCACGAAACTC
5047 Left AGTCATGATATGATCCTTTGAGAGC
5048 Right CTGACATACTCCCAAGGAAAGTAAA 5( 169 Left CTACTGCCATGATGCTTTAAAAGTT
5070 Right GAAACCCAAGGTACATTTCAGATAA
5( 171 Left AGAGCACTGTGAAGTCTCTACATGA
5049 Left AGTCATGATATGATCCTTTGAGAGC 5( 172 Right CTGACATACTCCCAAGGAAAGTAAA
5050 Right AATTTCTACCCTCTCACGAAACTCT
5( 173 Left AGAGCACTGTGAAGTCTCTACATGA
5051 Left AGTCATGATATGATCCTTTGAGAGC 5( 174 Right TGACATACTCCCAAGGAAAGTAAAG
5052 Right GATACAAATTTCTACCCTCTCACGA
5( 175 Left TCTGTAGCTGTTGCATATTGACTTC
5053 Left TCTGTAGCTGTTGCATATTGACTTC 5( 176 Right TAACTTGAAACCCAAGGTACATTTC
5054 Right CCAAGGAAAGTAAAGTTCCCATATT
5( 177 Left AGAGCACTGTGAAGTCTCTACATGA
5055 Left TTTTTCTGTAGCTGTTGCATATTGA 5( 178 Right AATTTCTACCCTCTCACGAAACTCT
5056 Right CCAAGGAAAGTAAAGTTCCCATATT
5( 179 Left AGTCATGATATGATCCTTTGAGAGC
5057 Left AGTCATGATATGATCCTTTGAGAGC 5( 180 Right ACGAAACTCTGAAATACACTTCCAA
5058 Right TAACTTGAAACCCAAGGTACATTTC
ERAS Exon2 801-1000 bases
Seq. 5( 188 Right TGACATACTCCCAAGGAAAGTAAAG
Primer Sequence
ID
5081 Left ATCCAGCTTTATTTGACACTCATTC 5( 189 Left AATATTGTTCTTCTTTGCCTCAGTG
5082 Right CCAAGGAAAGTAAAGTTCCCATATT 5( 190 Right CTGACATACTCCCAAGGAAAGTAAA
5083 Left CTACTGCCATGATGCTTTAAAAGTT 5( 191 Left ATCCAGCTTTATTTGACACTCATTC
5084 Right CCAAGGAAAGTAAAGTTCCCATATT 5( 192 Right TGACATACTCCCAAGGAAAGTAAAG
5085 Left ATCCAGCTTTATTTGACACTCATTC 5( 193 Left ATCCAGCTTTATTTGACACTCATTC
5086 Right CGAAACTCTGAAATACACTTCCAAT 5( 194 Right CTGACATACTCCCAAGGAAAGTAAA
Seq.
Primer Sequence
ID 181 Left TCCTCATCTATTCCTAATTGCTTTG
5161 Left CAGCCAATAAGTCTAGGTAGAGCAG 182 Right TTGAACTGAATTATAAGTGCCACAA
5162 Right TAAAGATGAAACAAACCAATCCAAT
183 Left TTTGCTTTTAAGAGATGGTAGATGG
5163 Left AGCCTTCTTAAATCTTGAGATCCAT 184 Right TCCTAACCCACTTTATCACATTCAT
5164 Right TCTTTGCAAATAGGCATTATTTCTC
185 Left GCACATTCATTAATTTGGAGCTACT
5165 Left ATTATGTGTTACATGAGGGAAAGGA 186 Right TAAAGATGAAACAAACCAATCCAAT
5166 Right TAAAGATGAAACAAACCAATCCAAT
187 Left GACTTAAACATGTGCATCTCCTTTT
5167 Left GGCTAGTAAACTTTTTGGCCTTAAC 188 Right AAATGACAACAAAGCAAAGGTAAAG
5168 Right TCTTTGCAAATAGGCATTATTTCTC
189 Left TCCTCATCTATTCCTAATTGCTTTG
5169 Left AGCCTTCTTAAATCTTGAGATCCAT 190 Right CCTTACTGAATAGGAAACTGTTCCA
5170 Right AATTAGACTGTTCCCCTTTACTGCT
Seq. 191 Left TTTGCTTTTAAGAGATGGTAGATGG
Primer Sequence
ID 192 Right AATTAGACTGTTCCCCTTTACTGCT
5171 Left GGCTAGTAAACTTTTTGGCCTTAAC
5172 Right TCCTAACCCACTTTATCACATTCAT 193 Left AGTCATGATATGATCCTTTGAGAGC
194 Right AATTAGCATGATTGCCTAGAAACAC
5173 Left GGCTAGTAAACTTTTTGGCCTTAAC
5174 Right AATTAGACTGTTCCCCTTTACTGCT 195 Left AGCCTTCTTAAATCTTGAGATCCAT
196 Right ACCAAAAATATGTGACGTTTCCTTA
5175 Left TTTGCTTTTAAGAGATGGTAGATGG
5176 Right TCTTTGCAAATAGGCATTATTTCTC 197 Left AGCCTTCTTAAATCTTGAGATCCAT
198 Right TACCAAAAATATGTGACGTTTCCTT
5177 Left CAGCCAATAAGTCTAGGTAGAGCAG
5178 Right TTGAACTGAATTATAAGTGCCACAA 199 Left AGCCTTCTTAAATCTTGAGATCCAT
200 Right TCAATTAGACTGTTCCCCTTTACTG
5179 Left GGCTAGTAAACTTTTTGGCCTTAAC
5180 Right TTGGAAACAAAGTGTAATGGAATTT
5213 Left tccaagcacaccatcctgag 222 Right gattcttccctggagcactgtccaa
5214 Right ccaaccatgcttccctgga
223 Left catcctgagtccgtggat
5215 Left ctgcacactggccgtct 224 Right agcactgtccaaccatgct
5216 Right ctcgaaatgggttgtctggac
225 Left tgagcactgcacact
5217 Left ccgtggatgaggagcagc 226 Right cccgattcttccctggagc
5218 Right gattcttccctggagcactgtc
Seq. 227 Left atgaggagcagcagt
Primer Sequence
ID 228 Right gacgcccgattcttccct
5219 Left gagcactgcacactggc
5220 Right cgattcttccctggagcact 229 Left gtgagcactgcac
230 Right aatgggttgtctggacgcc
ALK Regionl 176-225 bases
Seq.
Primer Sequence
ID 251 Left accatcctgagtccgtggat
5231 Left ctcctttctccttctcaacacct 252 Right ggccactcgaaatgggttg
5232 Right attcttccctggagcactgtc
Seq. 253 Left ccgtggatgaggagcagc
Primer Sequence
ID 254 Right ggagatgtattccagggcca
5233 Left cttctcaacacctcagctgact
5234 Right cgattcttccctggagcact 255 Left gagcactgcacactggc
5235 Left tttctccttctcaacacctcagct 256 Right gacaagctgcggtttccac
5236 Right gcactgtccaaccatgcttc
257 Left gcacaccatcctgagtcc
5237 Left ctgactccaagcacaccatc 258 Right gaaatgggttgtctggacgcc
5238 Right ctcgaaatgggttgtctggac
259 Left atgaggagcagcagtgag
5239 Left tccaagcacaccatcctgag 260 Right agggccactcgaaatggg
5240 Right ccactcgaaatgggttgtctg
261 Left ccgtggatgaggagc
5241 Left cctgagtccgtggatgagg 262 Right cccgattcttccctggagc
5242 Right gagatgtattccagggccactc
c 263 Left tgagcactgcacact
5243 Left ttctcaacacctcagctgactccaa s 264 Right aagctgcggtttccactgg
5244 Right gattcttccctggagcactgtccaa
s 265 Left atgaggagcagcagt
5245 Left gaggctcctttctccttctca s 266 Right ggacgcccgattcttccc
5246 Right ctggagcactgtccaacca
s 267 Left gtgagcactgcac
5247 Left ctcagctgactccaagcaca ί 268 Right tccactggagatgtattcca
5248 Right gagcactgtccaaccatgc
ί 269 Left ttctccttctcaaca
5249 Left acaccatcctgagtccgtg ί 270 Right gcccgattcttccctgg
5250 Right ttccagggccactcgaaat
ALK Regionl 226-275 bases
Seq. 5273 Left gaggctcctttctccttctcaa
Primer Sequence
ID 5274 Right ccactcgaaatgggttgtctg
5271 Left ctcctttctccttctcaacacct
5272 Right ctcgaaatgggttgtctggac ¾75 Left cttctcaacacctcagctgactc
¾76 Right gagatgtattccagggccactc
g t caaagaagtccactgcagacaag
5337 Left gaggctgcaagagagatcct 5352 Right agacaagctgcggttt
5338 Right cttcactgcagttcttcaggg
5353 Left tcctcctgatgccca
5339 Left cacaacgaggctgcaagag 5354 Right gatgttccttcactgcagtt
5340 Right gcaaagaagtccactgcagac
5355 Left gccccacaacgaggct
5341 Left ctctggaaggtacattgcccag 5356 Right tccactggagatgtattc
5342 Right caagctgcggtttccactg
5357 Left gctgctgccccacaac
5343 Left gaaggtacattgcccagctg 5358 Right ggcaaagaagtccact
5344 Right agacaagctgcggtttcca
5359 Left ctctggaaggtacattgcc
5345 Left tcctcctgatgcccactc 5360 Right agacaagctgcgg
5346 Right ctgcagttcttcagggcaaag
5361 Left cacctgcagccctct
5347 Left cccacaacgaggctgcaa 5362 Right tccactggagatgta
5348 Right ggcaaagaagtccactgca
Seq. 5363 Left agagatcctcctga
Primer Sequence
ID 5364 Right gatgttccttcactgca
5349 Left tgctgccccacaacgag 5365 Left ctgctgccccac
5350 Right ttcagggcaaagaagtcc 5366 Right tcagggcaaagaag
5351 Left gtacattgcccagctgctg
ALK Region2 176-225 bases
Seq. 5385 Left gagcactgcacactggc
Primer Sequence
ID 5386 Right gacaagctgcggtttccac
5367 Left gaaggtacattgcccagctg
5368 Right gatgttccttcactgcagttctt Seq.
Primer Sequence ID
5369 Left gaggctgcaagagagatcct 5387 Left actgcacactggccgtc
5370 Right gttccttcactgcagttcttcag 5388 Right aagctgcggtttccactgg
5371 Left gtacattgcccagctgctg 5389 Left tgctgccccacaacgag
5372 Right caaagaagtccactgcagacaag 5390 Right gctctgcagggccatct
5373 Left ctcctgatgcccactccag 5391 Left gccccacaacgaggct
5374 Right cattccaacaagtgaaggagctc 5392 Right gatgttccttcactgcagtt
5375 Left ctctggaaggtacattgccca 5393 Left cacctgcagccctct
5376 Right actgcagttcttcagggcaa 5394 Right gcaaagaagtccactgcagac
5377 Left cacaacgaggctgcaagagagat 5395 Left tcctcctgatgccca
5378 Right ctgcagttcttcagggcaaaga 5396 Right gactgtcccattccaacaagtg
5379 Left tcctcctgatgcccactc 5397 Left ctctggaaggtacattgc
5380 Right cccattccaacaagtgaaggag 5398 Right ggcaaagaagtccactgca
5381 Left acaacgaggctgcaagaga 5399 Left gctgctgccccacaac
5382 Right atcttggagcctggggatgttc 5400 Right ttcagggcaaagaagtcc
5383 Left ccacaacgaggctgcaag 5401 Left cgtctcggtgcacagg
5384 Right atcttggagcctggggatg 5402 Right agacaagctgcggtttc
5455 Left tcgagtggccctggaatac
5465 Left ggaatacatctccagtg 5466 Right cattccaacaagtgaag
ALK Region3 126-175 bases
Seq. 5481 Left gaagaatcgggcgtccaga
Primer Sequence
ID 5482 Right gactgtcccattccaacaa
5467 Left gtccagacaacccatttcgag
5468 Right cattccaacaagtgaaggagctc 5483 Left tcgagtggccctggaata
5484 Right ggaagtcacaggcctgcc
5469 Left gagtggccctggaatacatctc
5470 Right cccattccaacaagtgaaggag 5485 Left catttcgagtggccctgga
i486 Right cccattccaacaagtgaag
5471 Left cgagtggccctggaatacat
5472 Right gactgtcccattccaacaagtg 5487 Left ggcgtccagacaacccat
5488 Right caagctggaggactgtc
5473 Left gacagtgctccagggaagaat
5474 Right caacaagtgaaggagctctgc 5489 Left gaagaatcgggcgtccagacaa
5490 Right gactgtcccattccaa
5475 Left ggaagcatggttggacagtg 5491 Left ccatttcgagtggccct
5476 Right gctctgcagggccatct 5492 Right caagctggaggact
5477 Left tgctccagggaagaatcgg 5493 Left ggaagaatcgggcgtcc
5478 Right tgaaggagctctgcaggg 5494 Right ggactgtcccattc
Seq. 5495 Left ccatttcgagtggc
Primer Sequence
ID 5496 Right ggcctgcccaag
5479 Left gcgtccagacaacccatttc
5480 Right gagctctgcagggcca
ALK Region3 176-225 bases
Seq. 5512 Right ctctcatcttctccctgggc
Primer Sequence
ID
5497 Left gagtggccctggaatacatctc 5513 Left aacgaggctgcaagagagat
5498 Right acatctggctctcatcttctcc 5514 Right gctctgcagggccatct
5499 Left gacagtgctccagggaagaat 5515 Left gcatggttggacagtgctc
5500 Right cattccaacaagtgaaggagctc 5516 Right tgaaggagctctgcaggg
5501 Left ggaagcatggttggacagtg Seq.
Primer Sequence
5502 Right cccattccaacaagtgaaggag ID
5517 Left atggttggacagtgctccag
5503 Left ccagacaacccatttcgagtg 5518 Right ggaagtcacaggcctgcc
5504 Right atctggctctcatcttctccctg
5519 Left agggaagcatggttggaca
5505 Left cactccagggaagcatggtt 5520 Right gagctctgcagggcca
5506 Right gactgtcccattccaacaagtg
5521 Left tgctccagggaagaatcgg
5507 Left gaggctgcaagagagatcct 5522 Right gactgtcccattccaacaa
5508 Right caacaagtgaaggagctctgc
5523 Left tcgagtggccctggaat
5509 Left cgagtggccctggaataca 5524 Right gcagtttccggcacatctg
5510 Right gcacatctggctctcatcttc
5525 Left ctcctgatgcccactccag
5655 Left cccagaggctcctttctcc
5651 Left gctgactccaagcacaccat 5656 Right catcttggagcctg
5652 Right gactgtcccattccaa
5657 Left gcacaccatcctgagtcc
5653 Left ccgtggatgaggagcagc 5658 Right caagctggaggact
5654 Right tggaagtcacaggcc
ALK Region4 376-425 bases
Seq.
Primer Sequence
ID 5679 Left cccagaggctcctttctcc
5659 Left ctcctttctccttctcaacacct 5680 Right aaggagctctgcagggc
5660 Right gactgtcccattccaacaagtg
5681 Left ttctcaacacctcagctgactccaa
5661 Left gaggctcctttctccttctcaac 5682 Right gactgtcccattccaacaa
5662 Right cattccaacaagtgaaggagctc
5683 Left ccgtggatgaggagcagc
5663 Left ctccttctcaacacctcagct i684 Right cacaggcagtttccggc
5664 Right cccattccaacaagtgaaggag
5685 Left ctcagctgactccaagcaca
5665 Left c cagaggctc ctttctc cttc i686 Right caagctggaggactgtc
5666 Right caacaagtgaaggagctctgc
i687 Left tggggcagagcgttct
5667 Left acaccatcctgagtccgtg 1688 Right cccattccaacaagtgaag
5668 Right acatctggctctcatcttctcc
Seq. 5689 Left gcacaccatcctgagtcc
Primer Sequence
ID i690 Right ttctccctgggcaca
5669 Left ctccaagcacaccatcctga
5670 Right ctggctctcatcttctccctg 5691 Left ccgtggatgaggagc
5692 Right gcacatctggctctcatc
5671 Left accatcctgagtccgtggat
5672 Right gcacatctggctctcatcttc 5693 Left agagcgttctaaggagatg
5694 Right gactgtcccattccaa
5673 Left ctgactccaagcacaccatc
5674 Right ctctcatcttctccctgggc 5695 Left atgaggagcagcagt
5696 Right gcagtttccggcacat
5675 Left cttctcaacacctcagctgactc
5676 Right ggaagtcacaggcctgcc 5697 Left cccagaggctcctttc
5698 Right caagctggaggact
5677 Left cctgagtccgtggatgagg
5678 Right gcagtttccggcacatctg
ALK Region4 426-475 bases
Seq. 5705 Left cttctcaacacctcagctgactc
Primer Sequence
ID 5706 Right gcacatctggctctcatcttc
5699 Left ctcctttctccttctcaacacctc
5700 Right acatctggctctcatcttctcc 5707 Left acaccatcctgagtccgtg
5708 Right aagccatcttcaaagttgcagta
5701 Left gactccaagcacaccatcct
5702 Right agccatcttcaaagttgcagtaaaa 5709 Left agatggacttgctggatggg
5710 Right cattccaacaagtgaaggagctc
5703 Left gctcctttctccttctcaacac
5704 Right atctggctctcatcttctccctg 571 1 Left gaggctcctttctccttctcaa
5712 Right ctctcatcttctccctgggc
5725 Left cagagctggtcctggcg
5713 Left tttctccttctcaacacctcagct 5726 Right aacaagtgaaggagctctgca
5714 Right gcagtttccggcacatctg
5727 Left cagatggacttgctggat
5715 Left ccgcatcccctccgag 5728 Right gactgtcccattccaacaagtg
5716 Right cccattccaacaagtgaaggag
5729 Left ccatcctgagtccgtggat
5717 Left cctgagtccgtggatgagg 5730 Right gtccagccacagaagcc
5718 Right tccagccacagaagccatc
5731 Left ccgtggatgaggagcagc
Seq. 5732 Right tgtgccttgggtccagc
Primer Sequence
ID
5719 Left ccagaggctcctttctccttc 5733 Left ctcagctgactccaagcaca
5720 Right ggaagtcacaggcctgcc 5734 Right gcacatctggctctcatc
5721 Left ttctcaacacctcagctgactccaa 5735 Left tcctggcgccgcatc
5722 Right cacaggcagtttccggc 5736 Right tgaaggagctctgcaggg
5723 Left tccaagcacaccatcctgag 5737 Left gctgactccaagcacaccat
5724 Right aagccatcttcaaagttgca 5738 Right gcagtttccggcacat
ALK Region4 476-525 bases
Seq. 5758 Right tgacagtgtgccttgggtc
Primer Sequence
ID
5739 Left ctcctttctccttctcaacacct 5759 Left ccagaggctcctttctccttc
5740 Right agccatcttcaaagttgcagtaaaa 5760 Right gcagtttccggcacatctg
Seq.
Primer Sequence
ID 5761 Left aacacctcagctgactccaag
5741 Left gaggctcctttctccttctcaac 5762 Right agtgtgccttgggtccag
5742 Right aagccatcttcaaagttgcagta
5763 Left ctccaagcacaccatcctga
5743 Left gagtattcccctccactgcat 5764 Right agtgtggggtgacagtgtg
5744 Right cattccaacaagtgaaggagctc
5765 Left gtattcccctccactgcatgacctc
5745 Left tattcccctccactgcatgac 5766 Right tgaaggagctctgcaggg
5746 Right cccattccaacaagtgaaggag
5767 Left acaccatcctgagtccgtg
5747 Left agatggacttgctggatggg 5768 Right gtcctgacctgccattgag
5748 Right acatctggctctcatcttctcc
5769 Left ctcagctgactccaagcaca
5749 Left cactgcatgacctcaggaac 5770 Right ggggtgacagtgtgcctt
5750 Right gactgtcccattccaacaagtg
5771 Left cccagaggctcctttctcc
5751 Left gcatgacctcaggaaccaga 5772 Right aagccatcttcaaagttgca
5752 Right caacaagtgaaggagctctgc
5773 Left agagcgttctaaggagatg
5753 Left cttctcaacacctcagctgactc 5774 Right gcacatctggctctcatcttc
5754 Right tccagccacagaagccatc
5775 Left accatcctgagtccgtggat
5755 Left ctgactccaagcacaccatc 5776 Right gtccagccacagaagcc
5756 Right attgaggagtgtggggtgac
5777 Left tccactgcatgacctcagg
5757 Left ctccttctcaacacctcagct 5778 Right gactgtcccattccaacaa
ALK Region4 750-1250 bases
Seq.
Primer Sequence
ID 5799 Left cctgattattttacatggaatctcacc
5779 Left tggaatctcacctggataatgaaag 5800 Right tgtcagacacatcgaggagag
5780 Right ttttgttctccactagcaccaag
5801 Left ctcctttctccttctcaacacctc
5781 Left gaatcaccaacaaacatgccttc 5802 Right ctccttcccggttttgttctc
5782 Right agccatcttcaaagttgcagtaaaa
5803 Left gctcctttctccttctcaacac
5783 Left cacctggataatgaaagactccttc 5804 Right tttgttctccactagcaccaaggac
5784 Right tggtcactgtagcactttcagaa
5805 Left aaagactccttccctttcctgt
5785 Left tggataatgaaagactccttccctt 5806 Right ctcaagactccacgaatgagc
5786 Right caatagagcatggtcttggtgg
5787 Left attttacatggaatctcacctggat
5788 Right gaaacgtagcactggtcactgtag 5807 Left aatcaccaacaaacatgccttctcc
5808 Right ctagcaccaaggacacgtttc
5789 Left atctcacctggataatgaaagactc
5790 Right cttcccggttttgttctccactag 5809 Left cttctccttctcctgattattttaca
5810 Right cttcc cggttttgttctc cac
5791 Left tccttctcctgattattttacatgga
5792 Right aagccatcttcaaagttgcagta 5811 Left tctcctgattattttacatggaatctc
5812 Right gtagcactggtcactgtagcacttt
Seq. 5813 Left gactggtcatagctccttgga
Primer Sequence
ID 5814 Right gcacatctggctctcatcttc
5793 Left acatggaatctcacctggataatga
5794 Right gaaacgtagcactggtcactg 5815 Left gagaagaaggcgtcggaagt
5816 Right cattccaacaagtgaaggagctc
5795 Left gactggtcatagctccttggaatc
5796 Right ggttttgttctccactagcacc 5817 Left gatcttcgggactggtcatagctc
5818 Right atctggctctcatcttctccctg
5797 Left cagatcttcgggactggtcatag
5798 Right acatctggctctcatcttctcc
5829 Left CTTGTGGAGCCTCTTACACCCAGT 842 Right GGGATCCAGAGTCCCTTAT
5830 Right TGATAGCGACGGGAATTTTAACT
843 Left CTTGTGGAGCCTCTT
5831 Left GGAGAGGGAGCTTGTGGAG 844 Right CCTTGATAGCGACGGGAATTTTA
5832 Right GGGATCCAGAGTCCCTTATACA
845 Left GAGAAGCTCCCAA
5833 Left CTTGTGGAGCCTCTTACA 846 Right GCGACGGGAATTTTAACTTTCT
5834 Right CGACGGGAATTTTAACTTTCTCAC
847 Left GCACGCTGCGGA
5835 Left CTGCAGGAGAGGGAGCTTG 848 Right TGGGATCCAGAGTCCC
5836 Right AATTTTAACTTTCTCACCTTCTG
849 Left CCCAGTGGAGAAG
5837 Left CCCAGTGGAGAAGCTC 850 Right TCTCTTAATTCCTTGATAGCG
5838 Right TTCTCTTAATTCCTTGATAGCGACG
851 Left CGGAGGCTGCTG
5839 Left GAGAAGCTCCCAACCA 852 Right TGGGATCCAGAGT
5840 Right CTTAATTCCTTGATAGCGACGGGAA
Seq. 853 Left TGCTGCAGGAGAG
Primer Sequence
ID 854 Right CTTCTGGGATCCA
EGFR Regionl 176-225 bases
Seq. 872 Right TCCTTGATAGCGACGGGAATTT
Primer Sequence
ID
5855 Left TTGTGGAGCCTCTTACACCC 873 Left GCGCCACATCGTTCGGAA
5856 Right TTCTCTTAATTCCTTGATAGCGACG 874 Right AATTTTAACTTTCTCACCTTCTG
5875 Left GGATCGGCCTCTTCATGC
Seq. 876 Right GGGATCCAGAGTCCCTTAT
Primer Sequence
ID
5857 Left CAGGAGAGGGAGCTTGTGG 877 Left CCCAGTGGAGAAGCTC
5858 Right ACGGGAATTTTAACTTTCTCACCTT 878 Right ACGTAGGCTTCATCGAGGATTT
5879 Left CTTGTGGAGCCTCTTACA
5859 Left CTGCAGGAGAGGGAGCTTG 880 Right CCTTGTTGGCTTTCGGAGA
5860 Right TGATAGCGACGGGAATTTTAACTT
881 Left GAGAAGCTCCCAACCA
5861 Left CTTGTGGAGCCTCTTACACCCAGT 882 Right CACGTAGGCTTCATCGAGGA
5862 Right CTTAATTCCTTGATAGCGACGGGAA
883 Left CGAAGGCGCCACATCG
5863 Left CCACATCGTTCGGAAGCG 884 Right TGGGATCCAGAGTCCC
5864 Right CGACGGGAATTTTAACTTTCTCAC
885 Left TGCTGCAGGAGAGG
5865 Left CATCGTTCGGAAGCGCAC 886 Right AGATGTTGCTTCTCTTAATTCC
5866 Right CCTTGATAGCGACGGGAATTTTAA
887 Left GCACGCTGCGGA
5867 Left ATCGGCCTCTTCATGCGAA 888 Right TTCTCTTAATTCCTTGATAGCG
5868 Right GGGATCCAGAGTCCCTTATACA
889 Left CCCAGTGGAGAAG
5869 Left GAAGGCGCCACATCGTTC 890 Right GGCCATCACGTAGGCTTCAT
5870 Right GCGACGGGAATTTTAACTTTCT
891 Left CTTGTGGAGCCTCTT
5871 Left TGCTGCAGGAGAGGGAG 892 Right TCGGAGATGTTGCTTCT
5948 Right ATTGTCTTTGTGTTCCCGGACATA i 956 Right AGGAGGCAGCCG
5949 Left TCGCTATCAAGGAATTAAGAGAAGC I 957 Left TTAAAATTCCCGTCGCTATCAAGG
5950 Right CCAGGAGGCAGCCGAAG I 958 Right CGAAGGGCATGAG
5951 Left GGAAATCCTCGATGAAGCC I 959 Left GGAAATCCTCGATGAA
5952 Right GGGAGCCAATATTGTCTTTGTGT I 960 Right TGGGAGCCAATATTGTCTTTG
Seq.
Primer Sequence
ID I 961 Left CAACAAGGAAATCC
5953 Left CAAGGAATTAAGAGAAGCAACATCT I 962 Right TGGGAGCCAATATTGTCT
5954 Right GACATAGTCCAGGAGG
5955 Left CCGTCGCTATCAAGGAATTAAGAG
EGFR Region2 176-225 bases
Seq.
Primer Sequence
ID 5 983 Left TTAAAATTCCCGTCGCTATCAAGG
5963 Left GAAAGTTAAAATTCCCGTCGCTATC J 984 Right CCAGGAGGCAGCCGAAG
5964 Right GAGCCAATATTGTCTTTGTGTTCC
J 985 Left GAAGCAACATCTCCGAAAGCCAA
5965 Left GAAGGTGAGAAAGTTAAAATTCCCG J 986 Right CGATCTGCACACACCAGTT
5966 Right ATTGTCTTTGTGTTCCCGGACATAG
J 987 Left AATTCCCGTCGCTATCAAGGAATTA
5967 Left GTGAGAAAGTTAAAATTCCCGTCG J 988 Right TGGGAGCCAATATTGTCT
5968 Right AATATTGTCTTTGTGTTCCCGGAC
1 989 Left AAATCCTCGATGAAGCCT
5969 Left CCGTCGCTATCAAGGAATTAAGAG 5 990 Right CCTCCAAGTAGTTCATGCCCTTT
5970 Right GGGAGCCAATATTGTCTTTGTGT
1 991 Left TCAAGGAATTAAGAGAAGCAACATCT
5971 Left GAAATCCTCGATGAAGCCTACG J 992 Right GACATAGTCCAGGAGG
5972 Right GACGGTCCTCCAAGTAGTTCAT
Seq. 1 993 Left TATCAAGGAATTAAGAGAAGCAACA
Primer Sequence
ID 5 994 Right GGTACTGGGAGCCA
5973 Left TCGCTATCAAGGAATTAAGAGAAGC
5974 Right TGGGAGCCAATATTGTCTTTG 5 995 Left CCCAGAAGGTGAGAAAGTTAAAAT
5 996 Right AGGAGGCAGCCG
5975 Left AGAAGCAACATCTCCGAAAGC
5976 Right GATCTGCACACACCAGTTGAG 5 997 Left AGAAGCAACATCTCCGAA
5 998 Right CGATCTGCACACACCA
5977 Left GAAATCCTCGATGAAGCCTACGTGA
5978 Right CGACGGTCCTCCAAGTAGTT 5 999 Left GAAATCCTCGATGAAG
6 000 Right GCGACGGTCCTCCAAGTA
5979 Left CTCGATGAAGCCTACGTGATGG
5980 Right TCCTCCAAGTAGTTCATGCCC 6 001 Left GGCACGGTGTATAAGGGAC
6 002 Right CGAAGGGCATGAG
5981 Left CAACATCTCCGAAAGCCAACAA
5982 Right CACACACCAGTTGAGCAGG
EGFR Region2 226-275 bases
Seq. 6 005 Left GAAAGTTAAAATTCCCGTCGCTATC
Primer Sequence
ID _6 006 Right TGGGAGCCAATATTGTCTTTGTG
6003 Left AAGGTGAGAAAGTTAAAATTCCCGT
6004 Right GGAGCCAATATTGTCTTTGTGTTC 6 007 Left TCGCTATCAAGGAATTAAGAGAAGC
6 008 Right GACGGTCCTCCAAGTAGTTCAT
6025 Left CCCAGAAGGTGAGAAAGTTAAAAT
6009 Left GTGAGAAAGTTAAAATTCCCGTCGC 6 026 Right GTCTTTGTGTTCCCGGACATA
6010 Right CCAATATTGTCTTTGTGTTCCCG
6 027 Left AATTCCCGTCGCTATCAAGGAAT
6011 Left CCGTCGCTATCAAGGAATTAAGAG 6 028 Right CGATCTGCACACACCAGTT
6012 Right CCTCCAAGTAGTTCATGCCCTTT
6 029 Left AACATCTCCGAAAGCCAACAAG
6013 Left TCAAGGAATTAAGAGAAGCAACATC Γ6 030 Right AAGCGACGGTCCTCCAAGTA
6014 Right TCCTCCAAGTAGTTCATGCCC
6 031 Left GGCACGGTGTATAAGGGAC
6015 Left TTAAAATTCCCGTCGCTATCAAGG 6 032 Right CTTTGTGTTCCCGGACATAGTC
6016 Right GATCTGCACACACCAGTTGAG
6 033 Left TCGATGAAGCCTACGTGATGG
6017 Left GAAATCCTCGATGAAGCCTACG 6 034 Right GACATGCTGCGGTGTTTTCA
6018 Right TGTTTTCACCAGTACGTTCCTG
6 035 Left GAAATCCTCGATGAAGCCTACGTGA
6019 Left AGAAGGTGAGAAAGTTAAAATTCC 6 036 Right AGTACGTTCCTGGCTGCC
6020 Right ATATTGTCTTTGTGTTCCCGGAC
6 037 Left AGAAGCAACATCTCCGAAAGC
6021 Left TATCAAGGAATTAAGAGAAGCAACA 6 038 Right CAAGCGACGGTCCTCCAA
6022 Right CGACGGTCCTCCAAGTAGTT
6 039 Left AAAAGATCAAAGTGCTGGGCTC
Seq. 6 040 Right CCAGGAGGCAGCCGAAG
Primer Sequence
ID
6023 Left ATTCCCGTCGCTATCAAGGAATTAA ~ 041 Left GAAGCAACATCTCCGAAAGCCAAC
6024 Right CACACACCAGTTGAGCAGG 6 042 Right CTGCCAGGTCGCGGT
EGFR Region3 75-125 bases
Seq. ( 045 Left AAAGGGCATGAACTACTTGGAGGAC
Primer Sequence
ID ( 046 Right CACCCAGCAGTTTG
6043 Left CAAAGGGCATGAACTACTTGGAG ( 047 Left GCATGAACTACTTG
6044 Right CCAGCAGTTTGGCC ( 048 Right TTCCGCACCCAG
Seq.
Primer Sequence
ID
EGFR Region3 126-175 bases
Seq. ( 059 Left AAAGGGCATGAACTACTTG
Primer Sequence
ID J 060 Right GCCTCCTTCTGCATGGTATTCT
6049 Left CAAAGGGCATGAACTACTTGGAG Seq.
Primer Sequence
6050 Right CCTTCTGCATGGTATTCTTTCTCTT ID
( 061 Left GGCTCCCAGTACCTGCTC
6051 Left AAAGGGCATGAACTACTTGGAGGAC ( 062 Right CCAGCAGTTTGGCC
6052 Right CCTCCTTCTGCATGGTATTCTTTC
( 063 Left CAAAGGGCATGAACTAC
6053 Left CAACTGGTGTGTGCAGATCG ( 064 Right CACTTTGCCTCCTTCTGC
6054 Right CTGCATGGTATTCTTTCTCTTCCG
( 065 Left GCTCAACTGGTGTGTGCAGA
6055 Left CTCCCAGTACCTGCTCAACT ( 066 Right CACCCAGCAGTTTG
6056 Right CTTTCTCTTCCGCACCCAG
( 067 Left CAGATCGCAAAGGG
6057 Left GCTCAACTGGTGTGTGC ( 068 Right GCCTCCTTCTGCATGGTAT
6058 Right CATGGTATTCTTTCTCTTCCGCAC
( 069 Left CAAAGGGCATGAA
6070 Right GCCTCCTTCTGCATGG
EGFR Region3 176-225 bases
Seq. 090 Right TTTCTCTTCCGCACCCAG
Primer Sequence
ID
6071 Left CAAAGGGCATGAACTACTTGGAG 1 091 Left CAAAGGGCATGAACTACTTG
6072 Right CTCTGGTGGGTATAGATTCTGTGTA J 092 Right AGATTCTGTGTAAAATTGATTCCA
6073 Left CTATGTCCGGGAACACAAAGAC 1 093 Left TGGCTCCCAGTACCTG
6074 Right CCTTCTGCATGGTATTCTTTCTCTT J 094 Right CACTTTGCCTCCTTCTGC
6075 Left GACTATGTCCGGGAACACAAA 095 Left GACTATGTCCGGGAACAC
6076 Right CCTCCTTCTGCATGGTATTCTTTC J 096 Right GCCTCCTTCTGCATGG
6077 Left AAAGGGCATGAACTACTTGGAGGAC 1 097 Left CTTCGGCTGCCTCCTGG
6078 Right ACTCTGGTGGGTATAGATTCTGT 098 Right CCAGCAGTTTGGCC
6079 Left CTCCCAGTACCTGCTCAACT 1 099 Left AAAGGGCATGAACTAC
6080 Right CTGCATGGTATTCTTTCTCTTCCG J 100 Right ACTCTGGTGGGTATAGATTC
6081 Left CTCAACTGGTGTGTGCAGATC 1 101 Left CTGCTCAACTGGTGT
6082 Right GCCTCCTTCTGCATGGTATTCT J 102 Right TTCCAATGCCATCCACTT
6083 Left GGCTCCCAGTACCTGCTC 1 103 Left CCCTTCGGCTGCCTCC
6084 Right CATGGTATTCTTTCTCTTCCGCAC J 104 Right CACCCAGCAGTTTG
6085 Left GTCCGGGAACACAAAGACAATATT 1 105 Left ACAATATTGGCTCCCA
6086 Right GCCTCCTTCTGCATGGTAT J 106 Right ATCCACTTGATAGGCAC
6087 Left CTGCTCAACTGGTGTGTGC 107 Left CAGATCGCAAAGGG
6088 Right TTCCAATGCCATCCACTTGAT J 108 Right AGATTCTGTGTAAAATTGAT
Seq. 1 109 Left CAAAGGGCATGAAC
Primer Sequence
ID ( 110 Right CTCTGGTGGGTATAGA
6089 Left GTCCGGGAACACAAAGACAAT
EGFR Region3 226-275 bases
Seq. ( 120 Right CCTCCTTCTGCATGGTATTCTTTC
Primer Sequence
ID
6111 Left GTCCGGGAACACAAAGACAATATT 1 121 Left CTCCACCGTGCAGCTCAT
6112 Right ATTCCAATGCCATCCACTTGAT 122 Right CTGCATGGTATTCTTTCTCTTCCG
6113 Left CTCCCAGTACCTGCTCAACT 1 123 Left CGTGCAGCTCATCACGC
6114 Right CTCTGGTGGGTATAGATTCTGTGTA J 124 Right CATGGTATTCTTTCTCTTCCGCAC
6115 Left GCTCATCACGCAGCTCATG 1 125 Left CTATGTCCGGGAACACAAAGAC
6116 Right CCTTCTGCATGGTATTCTTTCTCTT J 126 Right GATTCTGTGTAAAATTGATTCCA
6117 Left CAACTGGTGTGTGCAGATCG 1 127 Left GCTCAACTGGTGTGTGCAG
6118 Right ACTCTGGTGGGTATAGATTCTGT J 128 Right CCGTAGCTCCAGACATCACT
6119 Left CAGCTCATCACGCAGCTC ( 129 Left CTATGTCCGGGAACACAAAGACAAT
6189 Left GAGAAGCTCCCAACC 193 Left TGTGGAGCCTCT
6190 Right TGGGAGCCAATATTGT t 194 Right TACTGGGAGCCA
6191 Left TCGGAAGCGCACG
6192 Right AGGAGGCAGCCG
EGFR Region4 376-425 bases
Seq.
Primer Sequence
ID 5215 Left GAGAAGCTCCCAACCAAG
6195 Left AGGAGAGGGAGCTTGTGGA 5216 Right CGACGGTCCTCCAAGTAGTT
6196 Right GAGCCAATATTGTCTTTGTGTTCC
5217 Left CTTGTGGAGCCTCTTACA
6197 Left GAAGGCGCCACATCGTTC 5218 Right CACACACCAGTTGAGCAGG
6198 Right AATATTGTCTTTGTGTTCCCGGAC
5219 Left CCCAGTGGAGAAGCTC
6199 Left TTGTGGAGCCTCTTACACCC 5220 Right AAGCGACGGTCCTCCAAGTA
6200 Right CTCCAAGTAGTTCATGCCCTTT
5221 Left CGCCACATCGTTCGGAA
6201 Left CCACATCGTTCGGAAGCG 5222 Right TGGGAGCCAATATTGTCT
6202 Right GGGAGCCAATATTGTCTTTGTGT
5223 Left CTCCCAACCAAGCTCT
6203 Left CTGCAGGAGAGGGAGCTTG 5224 Right CAAGCGACGGTCCTCCAA
6204 Right TTGTCTTTGTGTTCCCGGACATAG
5225 Left GAGAAGCTCCCAACC
6205 Left TGGAGCCTCTTACACCCAGT 5226 Right CGATCTGCACACACCAGTT
6206 Right TCCTCCAAGTAGTTCATGCCC
5227 Left TCTCTTGAGGATCTTGA
6207 Left CTCCCAACCAAGCTCTCTT 5228 Right GTACGTTCCTGGCTGCCA
6208 Right GACGGTCCTCCAAGTAGTTCAT
5229 Left GGATCGGCCTCTTCATGC
6209 Left TGCTGCAGGAGAGGGAG 5230 Right GACATAGTCCAGGAGG
6210 Right GATCTGCACACACCAGTTGAG
Seq. 5231 Left CTGGTGGTGGCCCTGG
Primer Sequence
ID 5232 Right AGGAGGCAGCCG
621 1 Left CATCGTTCGGAAGCGCAC
6212 Right TGGGAGCCAATATTGTCTTTG 5233 Left CCTCTTGCTGCTGGTGGT
5234 Right CGAAGGGCATGAG
6213 Left ATCGGCCTCTTCATGCGAA
6214 Right CCAGGAGGCAGCCGAAG
EGFR Region4 426-475 bases
Seq. t 242 Right GGGAGCCAATATTGTCTTTGTGT
Primer Sequence
ID
6235 Left ATCGGCCTCTTCATGCGAA 1 243 Left CTTGTGGAGCCTCTTACACCCAGT
6236 Right GAGCCAATATTGTCTTTGTGTTCC J 244 Right CCTCCAAGTAGTTCATGCCCTTT
6237 Left CCTCCTCTTGCTGCTGGT ( 245 Left CCTCTTGCTGCTGGTGGT
6238 Right AATATTGTCTTTGTGTTCCCGGAC J 246 Right ATTGTCTTTGTGTTCCCGGACATAG
6239 Left TTGTGGAGCCTCTTACACCC ( 247 Left GGAGAGGGAGCTTGTGGAG
6240 Right GACGGTCCTCCAAGTAGTTCAT ( 248 Right TCCTCCAAGTAGTTCATGCCC
6241 Left GAAGGCGCCACATCGTTC 1 249 Left CCACATCGTTCGGAAGCG
6371 Left AACATCTCCGAAAGCCAACAAG 6381 Left GAAGCAACATCTCCGAAAGCCAAC
6372 Right CATCAACTCCCAAACAGTCACCCC 6 382 Right CACCCCGTAGCTCCAGAC
6373 Left AAATCCTCGATGAAGCCTACGTGA 6 383 Left TTAAAATTCCCGTCGCTATCAAGG
6374 Right AAACAGTCACCCCGTAGCTC 6 384 Right ACTCTGGTGGGTATAGATTC
6375 Left AAAGATCAAAGTGCTGGGCTCCGG 6 385 Left CAGAAGGTGAGAAAGTTAAAATTCC
6376 Right TGCATGGTATTCTTTCTCTTCCG 6 386 Right CACTTTGCCTCCTTCTGC
6377 Left GGAAATCCTCGATGAAGCCT 6 387 Left GGGCTCCGGTGCGTT
6378 Right AAGGTCATCAACTCCCAAACAG 6 388 Right GCCTCCTTCTGCATGGTATTCT
6379 Left GAGAAAGTTAAAATTCCCGTCGCTA
6380 Right ATTCCAATGCCATCCACTT
EGFR Region6 476-525 bases
Seq. ( )400 Right GCCTCCTTCTGCATGGTATTC
Primer Sequence
ID
6389 Left GGAGCCTCTTACACCCAGT j )401 Left TCTCTTGAGGATCTTGA
6390 Right TTCTGCATGGTATTCTTTCTCTTCC ( )402 Right ATTCCAATGCCATCCACTTGAT
6391 Left CTCCCAACCAAGCTCTCTT j i403 Left CTCCCAACCAAGCTCT
6392 Right CTCCTTCTGCATGGTATTCTTTCTC j )404 Right GCCTCCTTCTGCATGGTA
6393 Left CTTGTGGAGCCTCTTACAC ( )405 Left CTGCAGGAGAGGGAGCTTG
6394 Right CATGGTATTCTTTCTCTTCCGCAC j )406 Right CCAGCAGTTTGGCC
6395 Left GAGAAGCTCCCAACCAAG j )407 Left GAGAAGCTCCCAACC
6396 Right CCTCCTTCTGCATGGTATTCTTT j v408 Right CACTTTGCCTCCTTCTGC
6397 Left GGAGAGGGAGCTTGTGGA
6398 Right TTTCTCTTCCGCACCCAG
6409 Left TGCTGCAGGAGAGGGA
( 3410 Right CACCCAGCAGTTTG
Seq.
Primer Sequence
ID 411 Left CCCAGTGGAGAAG
6399 Left CCCAGTGGAGAAGCTC $412 Right GCCTCCTTCTGCATG
EGFR Region6 526-575 bases
Seq. )421 Left CTCCCAACCAAGCTCTCTT
Primer Sequence
ID >422 Right ATTCCAATGCCATCCACTTGAT
6413 Left CTTGTGGAGCCTCTTACACCCAG
6414 Right CCTTCTGCATGGTATTCTTTCTCTT >423 Left GAGAAGCTCCCAACCAAG
>424 Right GCCTCCTTCTGCATGGTATTCT
6415 Left CAGGAGAGGGAGCTTGTGG
6416 Right CTGCATGGTATTCTTTCTCTTCCG 3425 Left TGCAGGAGAGGGAGC
3426 Right CTTTCTCTTCCGCACCCAG
6417 Left CTGCAGGAGAGGGAGCTTG
6418 Right CCTCCTTCTGCATGGTATTCTTTC 3427 Left CCCAGTGGAGAAGCTC
3428 Right GCCTCCTTCTGCATGGTAT
6419 Left CTTGTGGAGCCTCTTACAC Seq.
Primer Sequence
6420 Right CATGGTATTCTTTCTCTTCCGCAC ID
3429 Left TCTCTTGAGGATCTTGA
6430 Right AGATTCTGTGTAAAATTGATTCCA >437 Left CATCGTTCGGAAGCGCAC
438 Right CACCCAGCAGTTTG
6431 Left CTCCCAACCAAGCTCT
6432 Right CACTTTGCCTCCTTCTGC >439 Left CTTGTGGAGCCTCTTA
)440 Right GCCTCCTTCTGCATGG
6433 Left CCACATCGTTCGGAAGCG
6434 Right CCAGCAGTTTGGCC 441 Left CCCAGTGGAGAAG
>442 Right ATCCACTTGATAGGCAC
6435 Left GAGAAGCTCCCAACC
6436 Right ATTCCAATGCCATCCACTT >443 Left CTTGTGGAGCCTC
>444 Right CACTTTGCCTCCTTC
EGFR Region6 576-625 bases
Seq.
Primer Sequence
ID 465 Left GAGAAGCTCCCAACCAAG
6445 Left CTTGTGGAGCCTCTTACACCCAG J 466 Right AGATTCTGTGTAAAATTGATTCCA
6446 Right CTCTGGTGGGTATAGATTCTGTGTA
1 467 Left GCGCCACATCGTTCGGAA
6447 Left CCACATCGTTCGGAAGCG j 468 Right GCCTCCTTCTGCATGGTAT
6448 Right CCTTCTGCATGGTATTCTTTCTCTT
469 Left CGAAGGCGCCACATCG
6449 Left ATCGGCCTCTTCATGCGAA j 470 Right CACTTTGCCTCCTTCTGC
6450 Right CATGGTATTCTTTCTCTTCCGCAC
471 Left TGCTGCAGGAGAGGGAG
6451 Left GAAGGCGCCACATCGTTC j 472 Right ATTCCAATGCCATCCACTT
6452 Right CCTCCTTCTGCATGGTATTCTTTC
1 473 Left CCCAGTGGAGAAGCTC
6453 Left CTTGTGGAGCCTCTTACACC 474 Right CCCGTAGCTCCAGACATCAC
6454 Right ACTCTGGTGGGTATAGATTCTGT
1 475 Left TCTCTTGAGGATCTTGA
6455 Left CAGGAGAGGGAGCTTGTGG J 476 Right AAAGGTCATCAACTCCCAAACAG
6456 Right ATTCCAATGCCATCCACTTGAT
1 477 Left CTCCCAACCAAGCTCT
6457 Left CGTTCGGAAGCGCACG J 478 Right AAACAGTCACCCCGTAGCTC
6458 Right CTGCATGGTATTCTTTCTCTTCCG
Seq.
Sequence 1 479 Left GAGAAGCTCCCAACC
Primer
ID ( 480 Right ACCCCGTAGCTCCAGACAT
6459 Left CTGCAGGAGAGGGAGCTTG
6460 Right GCCTCCTTCTGCATGGTATTCT ( 481 Left CTTGTGGAGCCTCTTAC
( 482 Right ACTCTGGTGGGTATAGATTC
6461 Left CTCCCAACCAAGCTCTCTT
6462 Right CGTAGCTCCAGACATCACTCT ( 483 Left CTCTTGCTGCTGGTGGTG
( 484 Right CCAGCAGTTTGGCC
6463 Left GGATCGGCCTCTTCATGC
6464 Right CTTTCTCTTCCGCACCCAG
EGFR Region6 750-1250 bases
Seq.
Primer Sequence
ID ( 489 Left ACCAAAATTATAAGCAACAGAGGTG
6485 Left TTTGTGGAGAACTCTGAGTGCATA ( 490 Right CCTCCTTCTGCATGGTATTCTTT
6486 Right CTCTGGTGGGTATAGATTCTGTGTA
1 491 Left TATAAGCAACAGAGGTGAAAACAGC
6487 Left CAGGAGTCATGGGAGAAAACAAC J 492 Right ACTCTGGTGGGTATAGATTCTGT
6508 Right CATTTCTATCAATGCAAGCCACG
6612 Right ttttgaaggcttgtaactgct ( 622 Right gttttcctgagtactcctac
Seq. ( 623 Left cccctgcctcattacctg
Primer Sequence
ID ( 624 Right tgctgtcacattcaacattt
6613 Left cctcattacctggctcactaa
6614 Right cattttcactgccacatcaccat ( 625 Left aagtcatcttcatcctcag
( 626 Right tgaagagtaggatattcacatg
6615 Left gaaatctccaggacctcagcgagaa
6616 Right ctgaggtgtaggtgctgtca ( 627 Left ctcagcgagaaaggaagtca
( 628 Right tttgaaggcttgtaact
6617 Left agtcatcttcatcctcagaag
6618 Right gcccatgaagagtaggatattc ( 629 Left cctcattacctggctcac
( 630 Right tgctgtcacattcaaca
6619 Left ctcagcgagaaaggaagtcatct
6620 Right catgtcgtgttttcctga ( 631 Left caggtttgtctgctacccc
( 632 Right catcaccatgcca
6621 Left aaatctccaggacctcagcg
BRAF Regionl 276-325 bases
Seq.
Primer Sequence
ID
6633 Left aagtcatcttcatcctcagaagaca
6634 Right ggaatagcccatgaagagtaggata ( 653 Left aagccttacagaaatctccagga
t 654 Right ggaatagcccatgaagagtagg
6635 Left actaactaacgtgaaagccttacag
6636 Right tgaagagtaggatattcacatgtcg t 655 Left tattgatgacttgattagagac ca
( 656 Right caacattttcactgccacatcac
6637 Left ctcattacctggctcactaactaac
6638 Right ttttgaaggcttgtaactgctgag ( 657 Left ttgattagagaccaaggatttcgtg
( 658 Right tgctgtcacattcaacatttt
6639 Left aacgtgaaagccttacagaaatctc
6640 Right atagcccatgaagagtaggatattc ( 659 Left gctcactaactaacgtgaaagcctt
( 660 Right ttttgaaggcttgtaactgct
6641 Left ttgatgacttgattagagaccaagg
6642 Right attttcactgccacatcaccat ( 661 Left cttacagaaatctccaggacctca
6662 Right tgaagagtaggatattcacatg
Seq. t 663 Left cccctgcctcattacctgg
Primer Sequence
ID t 664 Right gtaactgctgaggtgtaggtgctg
6643 Left gatttcgtggtgatggaggatc
6644 Right gctgtcacattcaacattttcactg t 665 Left aaatctccaggacctcagcgagaaa
t 666 Right cagttgtggctttgtggaat
6645 Left attacctggctcactaactaacgtg
6646 Right gcttgtaactgctgaggtgtag t 667 Left ctcagcgagaaaggaagtcatct
t 668 Right ggtaacaatagccagttgtg
6647 Left caaggatttcgtggtgatggag
6648 Right tcacattcaacattttcactgcca t 669 Left atgacttgattagagaccaaggatt
t 670 Right aacattttcactgccacat
6649 Left cctcattacctggctcactaact
6650 Right cttgtaactgctgaggtgtaggtg 671 Left ctaacgtgaaagc cttacagaaat
( 672 Right catgtcgtgttttcctgag
6651 Left ctggctcactaactaacgtgaaag
( 745 Left actaacgtgaaagccttacagaaat
6737 Left ttacctggctcactaactaacgt ( 746 Right ctggagccctcacaccac
6738 Right ttggtctcaatgatatggagatg
( 747 Left aatctccaggacctcagcgagaaag
6739 Left gatttcgtggtgatggaggatc ( 748 Right ctgtcgtgcaatatctataagtttg
6740 Right ggaatagcccatgaagagtagg
( 749 Left gagaccgatcctcatcagctc
6741 Left ataaacacaatagaacctgtcaata ( 750 Right aacattttcactgccacatcaccat
6742 Right cttgtaactgctgaggtgtaggt
( 751 Left gaaatctccaggacctcagcgaga
6743 Left agaaatctccaggacctcagc ( 752 Right tgatcatctcaaatttggtctcaa
6744 Right cgtgcaatatctataagtttgatca
BRAF Regionl 426-475 bases
Seq.
Primer Sequence
ID ( 773 Left aagtcatcttcatcctcagaagaca
6753 Left actaacgtgaaagccttacagaaat ( 774 Right ggatgattgacttggcgtgtaag
6754 Right gcagtctgtcgtgcaatatctataa
t 775 Left gatcatcgaaatcaatttgggcaac
6755 Left ccttcaaaatccattccaattccac ( 776 Right cttgtaactgctgaggtgtaggt
6756 Right gctgtcacattcaacattttcactg
( 777 Left ctcactaactaacgtgaaagcctta
6757 Left attgatgacttgattagagaccaagg ( 778 Right gcagtctgtcgtgcaatatcta
6758 Right ggaatagcccatgaagagtaggata
( 779 Left gtccgtctccttcaaaatccatt
6759 Left actaactaacgtgaaagccttacag t 780 Right caacattttcactgccacatcac
6760 Right agtctgtcgtgcaatatctataagtt
t 781 Left attacctggctcactaactaacgtg
6761 Left gaagatcatcgaaatcaatttgggc ( 782 Right tgatcatctcaaatttggtctcaa
6762 Right ttttgaaggcttgtaactgctga
( 783 Left atattgatgacttgattagagacca
6763 Left tgcatataaacacaatagaacctgtc t 784 Right aatagcccatgaagagtaggatattc
6764 Right tgaagagtaggatattcacatgtcg
e 785 Left ctcagcgagaaaggaagtcatc
6765 Left caaaatccattccaattccacagc t 786 Right gaggtctctgtggatgattgactt
6766 Right cacattcaacattttcactgccac
t 787 Left ttacagaaatctccaggacctca
6767 Left aacgtgaaagccttacagaaatctc t 788 Right cttggcgtgtaagtaatccatgc
6768 Right gtgtaagtaatccatgccctgtg
Seq. 789 Left caaattctcaccagtccgtctc
Primer Sequence
ID 790 Right aacattttcactgccacatcaccat
6769 Left gatttcgtggtgatggaggatc
6770 Right gatatggagatggtgatacaagctg 791 Left ctggctcactaactaacgtgaaa
792 Right cgtgcaatatctataagtttgatcatct
6771 Left ctcattacctggctcactaactaac
6772 Right cgtgcaatatctataagtttgatca
BRAF Regionl 476-525 bases
Seq. t 795 Left tcactaactaacgtgaaagccttac
Primer Sequence
ID t 796 Right ttattactcttgaggtctctgtgga
6793 Left cttgattagagaccaaggatttcgt
6794 Right gatatggagatggtgatacaagctg t 797 Left gaagatcatcgaaatcaatttgggc
6924 Right tccagtcatcaattcatacaga
( 933 Left ttgagac caaatttgagatgatc
6925 Left gagatgatcaaacttatagatattgc ( 934 Right attctgatgacttctgg
6926 Right tctgactgaaagctgtatg
( 935 Left ctccagcttgtatcaccatctc
6927 Left tgtatcaccatctccatatcattga ( 936 Right tgccatccacaaa
6928 Right tgccatccacaaaatg
( 937 Left cacagggcatggat
6929 Left cacagggcatggattac ( 938 Right acagaacaattccaaatgca
6930 Right caattccaaatgcatatacatct
( 939 Left gagatgatcaaacttatagatat
6931 Left c cage ttgtatcac catctc cat ( 940 Right tttatcttgcattctga
BRAF Region2 276-325 bases
Seq.
Primer Sequence
ID ( 961 Left ttgagaccaaatttgagatgatc
6941 Left cagcttgtatcaccatctccatatc ( 962 Right acagaacaattccaaatgcatataca
6942 Right tctgactgaaagctgtatggatttt
( 963 Left cacagggcatggattactta
6943 Left atcac catctc catatcattgagac ( 964 Right ggtccctgttgttgatgtttgaa
6944 Right atgcatatacatctgactgaaagct
( 965 Left tgatcaaacttatagatattgcacgac
6945 Left acttatagatattgcacgacagactg ( 966 Right ctgtccagtcatcaattcata
6946 Right ctgtccagtcatcaattcatacaga
( 967 Left ccacaactggctattgttacc
6947 Left cacagggcatggattacttacac ( 968 Right attctgatgacttctggtgc
6948 Right aaaattatctggtccctgttgttga
( 969 Left ttgagac caaatttgagatg
6949 Left caaacttatagatattgcacgacaga ( 970 Right acaattccaaatgcatatacatctg
6950 Right ccaaatgcatatacatctgactgaa
i 971 Left ctccagcttgtatcaccatctcc
6951 Left gcatggattacttacacgccaa t 972 Right tctgactgaaagctgtatg
6952 Right attatctggtccctgttgttgatgt
t 973 Left gagatgatcaaacttatagat
6953 Left cacaactggctattgttacccag t 974 Right acagaacaattccaaatgcatat
6954 Right attctgatgacttctggtgccat
t 975 Left cacagggcatggattac
6955 Left gcttgtatcaccatctccatatcatt t 976 Right aaaattatctggtccctgttgt
6956 Right tctgactgaaagctgtatggat
( 977 Left tatcctactcttcatgggctattcc
6957 Left gcacgacagactgcacag t 978 Right cacaaaatggatccag
6958 Right cctgttgttgatgtttgaataaggt
Seq. t 979 Left attccacaaagccacaactg
Primer Sequence
ID t 980 Right tgccatccacaaaatg
6959 Left gagatgatcaaacttatagatattgc
6960 Right attccaaatgcatatacatctgact
BRAF Region2 326-375 bases
Seq. t 983 Left atcaccatctccatatcattgagac
Primer Sequence
ID 984 Right ctgtccagtcatcaattcatacaga
6981 Left ttatagatattgcacgacagactgc
6982 Right aaaattatctggtccctgttgttga ί 985 Left ccagcttgtatcaccatctccatat
986 Right tccaaatgcatatacatctgactga
003 Left agatgatcaaacttatagatattgcac
6987 Left cacaactggctattgttacccag 004 Right ggtccctgttgttgatgtttgaa
6988 Right tctgactgaaagctgtatggatttt
005 Left gcttgtatcaccatctccatatcatt
6989 Left tatcctactcttcatgggctattcc 006 Right ctgtccagtcatcaattcatac
6990 Right attctgatgacttctggtgccat
007 Left ccacaactggctattgttacc
6991 Left aacttatagatattgcacgacagac 008 Right acaattccaaatgcatatacatctgac
6992 Right tatctggtccctgttgttgatgttt
009 Left tgaatatcctactcttcatgggcta
6993 Left gcatggattacttacacgccaa 010 Right attctgatgacttctggtgc
6994 Right ttttggacagttactccgtacctta
on Left agatgatcaaacttatagatattg
6995 Left cacagggcatggattacttacac 012 Right c ctgttgttgatgtttgaataaggt
6996 Right ccgtaccttactgagatctggag
013 Left gcacgacagactgcacag
6997 Left tcaaacttatagatattgcacgaca 014 Right aggtatcctcgtcccaccata
6998 Right ggtatcctcgtcccaccataaaa
015 Left ttgagac caaatttgagatgatc
6999 Left ctccagcttgtatcaccatctcc 016 Right aaaattatctggtccctgttgt
7000 Right acagaacaattccaaatgcatataca
017 Left ccagtggtgtgagggctc
Seq. 018 Right tctgactgaaagctgtatggat
Primer Sequence
ID
7001 Left gctattccacaaagccacaac 019 Left cacagggcatggattactta
7002 Right aatgcatatacatctgactgaaagc 020 Right caggtatcctcgtcccacc
BRAF Region2 376-425 bases
Seq. 036 Right cttttggacagttactccgtacc
Primer Sequence
ID
7021 Left cagcttgtatcaccatctccatatc 037 Left ctccagcttgtatcaccatctcc
7022 Right aaaattatctggtccctgttgttga 038 Right attatctggtccctgttgttgatgt
7023 Left tgaatatcctactcttcatgggcta 039 Left acgacatgtgaatatcctactct
7024 Right tctgactgaaagctgtatggatttt 040 Right tccaaatgcatatacatctgactga
7025 Left tatcctactcttcatgggctattcc 041 Left tcagcagttacaagccttcaaaa
7026 Right ctgtccagtcatcaattcatacaga 042 Right ttctgatgacttctggtgccat
7027 Left cgacatgtgaatatcctactcttca 043 Left tgatcaaacttatagatattgcacg
7028 Right atgcatatacatctgactgaaagct 044 Right ccgtaccttactgagatctggag
7029 Left acttatagatattgcacgacagact 045 Left cacagggcatggattacttacac
7030 Right ttttggacagttactccgtacctta 046 Right ggcttttggacagttactccg
Seq.
Primer Sequence
ID 047 Left gcttgtatcaccatctccatatcatt
703 1 Left atcaccatctc catatcattgagac 048 Right aaaattatctggtccctgttgt
7032 Right ggtccctgttgttgatgtttgaa
049 Left gagatgatcaaacttatagatattgc
7033 Left ccacaactggctattgttaccc 050 Right ggtatcctcgtcccaccataaaa
7034 Right cctgttgttgatgtttgaataaggt
051 Left tgaatatcctactcttcatggg
7035 Left tcaaacttatagatattgcacgaca 052 Right acagaacaattccaaatgcatataca
71 16 Right ggtatcctcgtcccaccataaaa
129 Left ccagcttgtatcaccatctccatat
7117 Left catggtgatgtggcagtgaaaat 130 Right cactctgccattaatctcttcat
71 18 Right tctgactgaaagctgtatggatttt
13 1 Left tggaacagtctacaagggaaagt
71 19 Left tcagcagttacaagccttcaaaa 132 Right ttctgatgacttctggtgccat
7120 Right attatctggtccctgttgttgatgt
133 Left aacagtctacaagggaaagtggc
7121 Left gtctacaagggaaagtggcatg 134 Right attccaaatgcatatacatctgact
7122 Right atgcatatacatctgactgaaagct
135 Left ctacacctcagcagttacaagcc
7123 Left aacttatagatattgcacgacagac 136 Right ggtccctgttgttgatgtttgaa
7124 Right aatagaggcgagaatttgggga
137 Left tgacagcacctacacctcag
7125 Left ccacaactggctattgttaccc 138 Right acagaacaattccaaatgcatataca
7126 Right cttttggacagttactccgtacc
139 Left cacagggcatggattacttacac
7127 Left acctacacctcagcagttaca 140 Right aaggagggttctgatgcactg
7128 Right cctgttgttgatgtttgaataaggt
BRAF Region2 750-1250 bases
Seq.
Primer Sequence
ID 161 Left tgacttgattagagaccaaggattt
7141 Left taaatttcaccagcgttgtagtaca 162 Right gagaatttggggaaagagtggtc
7142 Right aaaattatctggtccctgttgttga
163 Left aattatgaccaacttgatttgctgt
7143 Left catgtggttataaatttcaccagcg 164 Right ggtccctgttgttgatgtttgaa
7144 Right ctgtccagtcatcaattcatacaga
165 Left cttgatttgctgtttgtctccaag
7145 Left cttgattagagaccaaggatttcgt 166 Right ggtatcctcgtcccaccataaaa
7146 Right ttttggacagttactccgtacctta
167 Left cctcattacctggctcactaactaa
7147 Left tatgaccaacttgatttgctgtttg 168 Right aatagaggcgagaatttgggga
7148 Right cctgttgttgatgtttgaataaggt
169 Left caaaatccattccaattccacagc
7149 Left gaagatcatcgaaatcaatttgggc 170 Right gcatatagactaaaatcctctgtttgg
7150 Right agtggtctctcatctcttttctttt
171 Left cgttgtagtacagaagttccactg
7151 Left ccttcaaaatccattccaattccac 172 Right tgttgttgatgtttgaataaggtaac
7152 Right attatctggtccctgttgttgatgt
173 Left gtctccttcaaaatccattccaatt
7153 Left tgatgacttgattagagaccaagga 174 Right ggcttttggacagttactccg
7154 Right cttttggacagttactccgtacc
175 Left cgtctccttcaaaatccattcca
7155 Left tggttataaatttcaccagcgttgt 176 Right agcatatagactaaaatcctctgtt
7156 Right acagaacaattccaaatgcatataca
Seq. 177 Left caacttgatttgctgtttgtctcc
Primer Sequence
ID 178 Right aggtatcctcgtcccaccata
7157 Left ttgtagtacagaagttccactgatg
7158 Right ccgtaccttactgagatctggag 179 Left tgcatataaacacaatagaacctgt
180 Right gcgagaatttggggaaagagtg
7159 Left gatcatcgaaatcaatttgggcaac
7160 Right aatagaggcgagaatttggggaaag
Seq. Primer Sequence
ID ??7 Left TCAGCGGCTCCC
7211 Left CCAGGTGCGGGAGAGAG 228 Right AGGAATCCTCTATTGTT
7212 Right ATCATATTCGTCCACAAAATGATTC
KRAS Regionl 176-225 bases
Seq. Primer Sequence ID
7229 Left ATTTCGGACTGGGAGCGAG ID
7230 Right ATTGTTGGATCATATTCGTCCACAA 247 Left AGCGGCTCCCAGGTGC
248 Right GCTGTGTCGAGAATATCCAAGAG
7231 Left CTCGGCCAGTACTCCCG
7232 Right TGGATCATATTCGTCCACAAAATGA 249 Left TCCCAGGTGCGGGAGAG
250 Right CTCTTGACCTGCTGTGTCGA
7233 Left CAGGTGCGGGAGAGAGG
7234 Right TCGAGAATATCCAAGAGACAGGTTT 251 Left CCAGAGGCTCAGCGG
252 Right CCTGCTGTGTCGAGAATATCCAA
7235 Left CTCAGCGGCTCCCAGG
7236 Right TCCATCAATTACTACTTGCTTCCTG 253 Left GCTCGGCCAGTACTC
254 Right TCATATTCGTCCACAAAATGATTCT
7237 Left GCCAGTACTCCCGGCC
7238 Right ATTCGTCCACAAAATGATTCTGAAT 255 Left CCCCGCCATTTCG
256 Right TCCTCTATTGTTGGATCATATTCGT
7239 Left TGCGGGAGAGAGGCCT
7240 Right TGTGTCGAGAATATCCAAGAGACAG 257 Left TCAGCGGCTCCC
258 Right TTGACCTGCTGTGTCGAGAATATC
7241 Left GCACTGAAGGCGGCG
7242 Right TCAATTACTACTTGCTTCCTGTAGG 259 Left GGCACTGAAGGCG
260 Right ATCCTCTATTGTTGGATCATATT
7243 Left GCTCCCAGGTGCGGGA
7244 Right GTTTCTCCATCAATTACTACTTGCT 261 Left CATTTCGGACTGGG
262 Right AGGAATCCTCTATTGTTGGA
7245 Left CATTTCGGACTGGGAGC 229
7246 Right TCTATTGTTGGATCATATTCGTCCA 230 Left CCAGAGGCTCAG
Right GTTTCTCCATCAATTACTACTT
Seq. Primer Sequence
ERAS Region2 75-125 bases
Seq. 242 Right TCCCCAGTCCTCATGTA
Primer Sequence
ID
7231 Left CTTGGATATTCTCGACACAGCAG 243 Left CTACAGGAAGCAAGTAGTAATTGA
7232 Right TTATGGCAAATACACAAAGAAAGCC 244 Right TCCCCAGTCCTCAT
7233 Left AACCTGTCTCTTGGATATTCTCGAC 245 Left AGAAACCTGTCTCTTGGATATT
7234 Right AAATACACAAAGAAAGCCCTCCC 246 Right GATTTAGTATTATTTATGGC
7235 Left GGAAGCAAGTAGTAATTGATGGAGA 247 Left AGAAACCTGTCTCTTGGA
7236 Right AATACACAAAGAAAGCCCTCCCCAG 248 Right GGCAAATACACAAAGAAA
7237 Left AGAAACCTGTCTCTTGGATATTCTC 249 Left AGAAACCTGTCTCTT
7238 Right TCCCCAGTCCTCATGTACTG 250 Right TTTATGGCAAATACACAAAG
7239 Left TGTCTCTTGGATATTCTCGACACAG 251 Left CAAGTAGTAATTGATGG
7240 Right AAAGAAAGCCCTCCCCAGTCC 252 Right ATGGCAAATACACA
Seq.
Primer Sequence
ID
7241 Left AGCAAGTAGTAATTGATGGAGAAAC
RAS Region2 126-175 bases
Seq. Primer Sequence ID
7253 Left TTTGTGGACGAATATGATCCAACAA ID
7254 Right TTATGGCAAATACACAAAGAAAGCC 273 Left CAGGAAGCAAGTAGTAATTGATGGA
274 Right GATTTAGTATTATTTATGGC
Left TGGACGAATATGATCCAACAATAGA
7255 G 275 Left AGAAACCTGTCTCTTGGATATTCT
7256 Right AAATACACAAAGAAAGCCCTCCC 276 Right AATTTGTTCTCTATAATGGT
7257 Left CTTGGATATTCTCGACACAGCAG 277 Left CTACAGGAAGCAAGTAGTAATTG
7258 Right AGGTACATCTTCAGAGTCCTTAAC 278 Right TTTATGGCAAATACACAAAG
7259 Left TTCAGAATCATTTTGTGGACGAATA 279 Left AGAAACCTGTCTCTTGGATAT
7260 Right AATACACAAAGAAAGCCCTCCCCAG 280 Right GTCCTTAACTCTTTTAATTTG
7261 Left CCTTGACGATACAGCTAATTCAGAA 281 Left ACAGCTAATTCAGAATCATTTTGTGG
7262 Right TCCCCAGTCCTCATGTACTG 282 Right TCCCCAGTCCTCAT
7263 Left CATTTTGTGGACGAATATGATCCAA 283 Left AGAAACCTGTCTCTTGG
7264 Right GAAAGCCCTCCCCAGTCC 284 Right ACTCTTTTAATTTGTTCTCT
7265 Left TGTCTCTTGGATATTCTCGACACAG 285 Left CTACAGGAAGCAAGTAGTAA
7266 Right GTCCTTAACTCTTTTAATTTGTTC 286 Right TATAATGGTGAATATCTTC
7267 Left AACCTGTCTCTTGGATATTCTCGA 287 Left TCCAACAATAGAGGATTCC
7268 Right TAATTTGTTCTCTATAATGGTGAA 288 Right TTTATGGCAAATACACA
7269 Left GCAAGTAGTAATTGATGGAGAAAC 289 Left AGAAACCTGTCTCT
7270 Right TTTATGGCAAATACACAAAGAAA 290 Right GTCCTTAACTCTTTTAAT
7271 Left TGACGATACAGCTAATTCAGAATCA
7272 Right TCCCCAGTCCTCATGTA
Seq. Primer Sequence
RAS Region2 176-225 bases
Seq.
Primer Sequence
ID 301 Left TACAGGAAGCAAGTAGTAA
7291 Left CCTTGACGATACAGCTAATTCAGAA 302 Right CCATAGGTACATCTTCAGAGTCCTT
7292 Right TTATGGCAAATACACAAAGAAAGCC
303 Left GCTAATTCAGAATCATTTTGTGGACG
7293 Left TTCAGAATCATTTTGTGGACGAATA 304 Right TTTATGGCAAATACACAAAG
7294 Right GCAAATACACAAAGAAAGCCCTC
305 Left GCAAGTAGTAATTGATGGAGAA
7295 Left CAGGAAGCAAGTAGTAATTGATGGA 306 Right GTACATCTTCAGAGTCCTTAAC
7296 Right CCATAGGTACATCTTCAGAGTC
307 Left GTGGACGAATATGATCCAACAATAG
7297 Left TGACGATACAGCTAATTCAGAATCA 308 Right AACTCTTTTAATTTGTTCTC
7298 Right TTTATGGCAAATACACAAAGAAA
309 Left CTACAGGAAGCAAGTAGTAATTGA
310 Right CCATAGGTACATCTTCAGA
Seq.
Primer Sequence
ID 311 Left TCATTTTGTGGACGAATATGATCCA
Left GGACGAATATGATCCAACAATAGAG 312 Right GATTTAGTATTATTTATGGC
7299 G
7300 Right TTTAATTTGTTCTCTATAATGGTG 313 Left ACAGCTAATTCAGAATCATTTTGTGG
7432 Right tgttctagaaggcaaatcacatttat 7445 Left GGCGGCGAAGGT
7446 Right atacacaaagaaagccctccccagt
7433 Left AGCGGCTCCCAGGTGC
7434 Right gcctgttttgtgtctactgttc 7447 Left GCGAAGGTGGCG
7448 Right caaagaaagccctccccagtcct
7435 Left GCCAGTACTCCCGGCC
7436 Right taatttgttctctataatggtgaa 7449 Left TCAGCGGCTCCC
7450 Right tctactgttctagaaggcaaat
7437 Left CATTTCGGACTGGGAGC 7419
7438 Right gtccttaactcttttaatttgttc 7420 Left CGGAGGCAGCAG
Right tttatggcaaatacacaaagaaa
7439 Left CCAGAGGCTCAGCGG 7421
7440 Right ccataggtacatcttcagagtc 7422 Left CCCCGCCATTTCG
Right gtccttaactcttttaatttg
7441 Left GCTCGGCCAGTACTC 7423
7442 Right ttatggcaaatacacaaagaaagccctc 7424 Left GGCACTGAAGGCG
Right ccataggtacatcttcaga
7443 Left AAGGTGGCGGCG 7425
7444 Right aaatacacaaagaaagccctcccc 7426 Left CATTTCGGACTGGG
Right actcttttaatttgttctct
KRAS Region3 426-475 bases
Seq. 7446 Right ttgctgatgtttcaataaaaggaat
Primer Sequence
ID
7427 Left ATTTCGGACTGGGAGCGAG 7447 Left CATTTCGGACTGGGAGC
7428 Right actgttctagaaggcaaatcacatt 7448 Right tgttctagaaggcaaatcacatttat
7429 Left GCTCGGCCAGTACTCCC 7449 Left GGCACTGAAGGCG
7430 Right ccataggtacatcttcagagtcctt 7450 Right ttcttgctaagtcctgagcctgttt
7431 Left GTGCGGGAGAGAGGCC 7451 Left GCTCGGCCAGTACT
7432 Right gtcttgtctttgctgatgtttcaat 7452 Right ccataggtacatcttcagagtc
7433 Left GCCAGTACTCCCGGCC 7453 Left AAGGTGGCGGCG
7434 Right taggtacatcttcagagtccttaac 7454 Right gtccttaactcttttaatttgttc
7435 Left CTCAGCGGCTCCCAGG 7455 Left GGCGGCGAAGGT
7436 Right agcctgttttgtgtctactgttc 7456 Right taatttgttctctataatggtgaa
7437 Left GCACTGAAGGCGGCG 7457 Left TCAGCGGCTCCC
7438 Right tctactgttctagaaggcaaatcac 7458 Right gaattccataacttcttgctaag
7439 Left CCAGGTGCGGGAGAGAG 7459 Left CATTTCGGACTGGG
7440 Right cttcttgctaagtcctgagcct 7460 Right tctactgttctagaaggcaaat
7441 Left GCTCCCAGGTGCGGGA 7461 Left CCCCGCCATTTCG
7442 Right tgctgatgtttcaataaaaggaattcc 7462 Right ccataggtacatcttcaga
7443 Left CCAGAGGCTCAGCGG 7463 Left GCGAAGGTGGCG
7444 Right gttttgtgtctactgttctagaagg 7464 Right gtccttaactcttttaatttg
Seq.
Primer Sequence
ID 7465 Left CCAGAGGCTCAG
Table 15: IRID Hybridization-based capture probes for NGS panel
7625 AAGTGAAGATGACAATCATGTTGCAGCAATTCACTGTAAAGCTGGAAAGGGACGAACT GGTGTAATGATATGTGCATATTTATTACATCGGGGCAA
7626
CCCATAGAAATCTAGGGCCTCTTGTGCCTTTAAAAATT
7627
CTCTTTTTTTTCTGTCCACCAGGGAGTAACTA
7628 ACATCATCTTGTGAAACAACAGTGCCACTGGTCTATAATCCAGATGATTCTTTAACAGG TAGCTATAATAATACACATAGCGCCTCTGACTGGGAAT
7629 TTTGAAACTATTCCAATGTTCAGTGGCGGAACTTGCAGTAAGTGCTTGAAATTCTCATC CTTCCATGTATTGGAACAGTTTTCTTAACCATATCTAGAAGTTTACATAAAAATTTAGA AAGAAATTT
7630
AAGGCATTTCCTGTGAAATAATAC
7631 CGTGTGGGTCCTGAATTGGAGGAATATATCTTCACCTTTAGCTGGCAGACCACAAACTG AGGATCTGCATGGTTAAATACATACCAGTATT
7632 GACGGGAAGACAAGTTCATGTACTTTGAGTTCCCTCAGCCGTTACCTGTGTGTGGTGAT ATCAAAGTAGAGTTCT
7633 TTATAGTTCCTTACATGTCATAAAATAAAATATAGCTTTTAATCTGTCCTTATTTTGGAT
7634 TAACATAGGTGACAGATTTTCTTTTTTAAAAAAATAAAACATCATTAATTAAATATGTC ATTTCATTTCTTTTTCTTTTCTTTTTTTTTTTTTTTAGGACAAAATGTTTCACTTTTGGGTA
7635
TGTATTTA
7636 TATGTGATCAAGAAATCGATAGCATTTGCAGTATAGAGCGTGCAGATAATGACAAGGA ATATCTAGTACTTACTTTAACAAAAAATGATCTTGACAAAGCAAATAAAGACAA
7637 TACAAGTCAACAACCCCCACAAAATGTTTAATTTAACTGACCTTAAAATTTGGAGAAAA GTATCGGTTGGCTT
7638 AGAGAAACCTTTATCTGTATCAAAGAATGGTCCTGCACCAGTAATATGCATATTAAAAC AAGATTTACCTCTATTGTTGGATCA
7639 CTGGTGGCGTAGGCAAGAGTGCCTTGACGATACAGCTAATTCAGAATCATTTTGTGGAC GAATATG
7640 GCTCCAACTACCACAAGTTTATATTCAGTCATTTTCAGCAGGCCTTATAATAAAAATAA TGAAAATGTGACTATATTAGAACATGTCACACATAAGGTTAATACA
7641 GCCCATGCCGTGGCTGCTGGTCCCCCTGCTGGGCCATGTCTGGCACTGCTTTCCAGCAT GGTGAGGGCTGAGGTGACCCTTGTCTCTGTGTTCTTGTCCCCCCCAGCTTGTGGAGCCT CTTACACC
7642 CAGAGGCCTGTGCCAGGGACCTTACCTTATACACCGTGCCGAACGCACCGGAGCCCAG TTCTCCACTGG
7643 CCTTCGGGGTGCATCGCTGGTAACATCCACCCAGATCACTGGGCAGCATGTGGCACCAT CTCACAATTGCCAGTTAACGTCTTCCT
7644 TCTCTTAATTCCTTGATAGCGACGGGAATTTTAACTTTCTCACCTTCTGGGATCCAGAGT CCCTATGACAGAGAGAGAAG
7645 AAGCAACATCTCCGAAAGCCAACAAGGAAATCCTCGATGTGAGTTTCTGCTTTGCTGTG TGGGGGTCCATGGCTCTGAACCTCAGGCCCACCTTTTCTCATGTCTGGCAGC
7646 ATTTTGAAACTCAAGATCGCATTCATGCGTCTTCACCTGGAAGGGGTCCATGTGCCCCT CCTTCTGGCCACCATGCGAAG
7647 GAGGTGAGGCAGATGCCCAGCAGGCGGCACACGTGGGGGTTGTCCACGCTGGCCATCA CGTAGGCTTCCTGGAGGGAGGGAGAGGCACGTCAGTGTGGC
7648 CCACCGTGCAGCTCATCACGCAGCTCATGCCCTTCGGCTGCCTCCTGGACTATGTCCGG GAACACAAAGACAATATTGGCTCCCAGTACCTGCTCAACTGGTGTGTGCAGATCGCAA AGGTAATCAGGGAAGGGA
7649 CGTGGAGAGGCTCAGAGCCTGGCATGAACATGACCCTGAATTCGGATGCAGAGCTTCT TCCCATGATGATCTGTCCCTCACAGCAGGGT
7650 GCGGTGTTTTCACCAGTACGTTCCTGGCTGCCAGGTCGCGGTGCACCAAGCGACGGTCC TCCAAGTAGTTCATGCCCTGAAACAGAGAAGACCCTGC
7651 CAGCATGTCAAGATCACAGATTTTGGGCTGGCCAAACTGCTGGGTGCGGAAGAGAAAG AATACCATGCAGAAGGAGGCAAAGTAAGGAGGTGGCTTTAGGTCAGCCAGCATTT
7652 GATTATCTGTCTGGCCCCAGACCTGGAGCTTTCTTTCCATGATAGGAGTACTTCTTTGGG TTGACTTCTCTGGTGACAG
7653 CTCATCAAGCTCTAGCTCCTCCAGCTTCTTCTGCAAGGCCTCCAAGTTGGTCCTGTTCCA AAGTGGGGAGCACAAGTCAATACT
7654 GCAGCAGCGAAAGCGCCTTGAGGCCTTTCTTACCCAGAAGCAGAAGGTGGGAGAACTG AAGGATGACGACTTTGAGAAGATCAGTGAGCTGGGGGCTGGCAATGGCGGTGTGGTGT
TCAAG
7655 CCCCAGGCTTCTAAGTACCCTGAGAAATAATCCAATTACCTGTTAATCAAGGCAAACTC ACCTTTCTGGCCATGACCAGGCCAGAAGGCTTGTGGGAGACC
7656 AAAATACTATAGTTGAGACCTTCAATGACTTTCTAGTAACTCAGCAGCATCTCAGGGCC AAAAATTTAATCAGTGGAAAAATAGCCTCA
7657 CTACAGTGAAATCTCGATGGAGTGGGTCCCATCAGTTTGAACAGTTGTCTGGATCCATT TTGTGGATGGTAAGAATT
7658 GCTAGACCAAAATCACCTATTTTTACTGTGAGGTCTTCATGAAGAAATATATCTGAGGT GTAGTAAGTAAAGGAAAACAGTAGAT
7659 ATATATACATAAGAGAGAAGGTTTGACTGCCATAAAAAATATCTAATTTATGACAATA AAAACCTTACTTTATTTGGATTTGAT
7660 ATATATAATAGCTTTTCTTCCATCTCTTAGGAAACTCCATGCTTAGAGTTGGAGTTTGAC TGGTTCAGCAGTGTGGTAAAGT
7661 TTATAATTGATACTTAATAAACTCAGTGATTTGCCTTACCAGTCCTGCGTGGGAATAGC TAAATCCTGCTTCTCGGGATACAGACCAATTGGCATGCTCTTCAATCACTGACATATCT GGGAA
7662 TTTCTCCTGCAGCTGTGTGGACCTGGATGACAAGGGCTGCCCCGCCGAGCAGAGAGCC AGGTTGGCCTGGACCC
7663 GCTAGGGACAACACGATTTCCCTTGGAGATATCGATCTGTTAGAAACCTCTCCAGGTTC TTTGGGGGCAGAG
7664 TCATGGAAGCCCTGATCATCAGGTAAAGCCACAGAGAGACACCCTCACCCCAACTCCC CTCTGCCCCCAAAGAAC
7665 GAGGAAATCCAGTTCGTCCTGTTCAGAGCACACTTCAGGCAGCGTCTGGGCAGAGAAG GGGAGGGTGGGGAGGAGGAGGAGGCTGTGA
7666 CAAGTGGCTGTGAAGGTAAGAAGTGGCTCACTCTTGAGCCTGCCCTTGGCTTGCGGACT CTGTAGGCTGCAGTTCTCAGCTC
7667 GCAGGGGGCTTGGGTCGTTGGGCATTCCGGACACCTGGCCTTCATACACCTCCCCAAAG GCGCCATGGCCCAGACCCCTGTGCAAAGGAGAAGACAAGAGG
7668 CCCTCTAGGGTTGTCAATGAAATGAATTCACCAACATAAAATGGTTTTGAAAAATCCTA AAGAGCTCTACCAATGTGAGTGACCATTATCACTCCT
7669 GCTGGGCTTTACACACAGAATCTACCCACTGAATCACAATTTTGTTCTGGCTTCCATGG AGTTTGCCTTCCAGAACATCCTCACATGTA
7670 CCCCCCAACACATGGGCCAGGGCAAATGAGTCACCCGCTATGTGCTCAGTTCCCTCCTC
TATGCAATGGACCGACCGTGATCAGATTAGGGTTACCTGAGGATCGAATGAATTGAAA TG
7671
GTTTTAGAAAATGAATAGTTGTTAAACCTGAATT
7672 AGAACCTTATTGAAATATGGCCAAAGTAAGTCAATAAACAGCCCTTAGTCCTCTTGAAA AAATTCAGGTTTAACAACTATTCATTTT
7673 TACCTTCCCATTTTGAACCTGGTAACTAATTCTGTAGGACATCATCTTCCAAAAAGCTTT ACTCTTGCTCTGCTAGCCTATCTAGCTAAAGAGCTTCTCTG
7674 GGCCACTTCCCAGCTGGCGCGGACACGGCAGGCTGGAGAGCCATGAGGCAGAGCATAC GCAGCCTGTACCCAGTGGTGCCGAGCCTCTGGCG
7675 CGATGAAGGAGAAGAGGACAGCGGCTGCGATCACCGTGCGGCACAGCTCGTCGCACA GTGGATCTGTGGGTGGGGGTGGTGTGAGGCTTGGCACCG
7676 CATCGTCTCGGTGCTGCTGTCTGCCTTCTGCATCCACTGCTACCACAAGTTTGCCCACAA GCCACCCATCTCCTCAGCTGAGATGAC
7677 GAGACCTGGTTCTCCATGGAGTCCAGCGAGGGCCGGCGGGCACCGGAAGAGGAGTAGC TGACCGGGAAGGCCTGGGCGGGCCTCCGGAAGG
7678 CCGTGGATGCCTTCAAGATCCTGGTGAGGGTCCCTGCGGGGCAGGGAAGATCCCCTGC CCTCCCCAGCTGCCTTCCAGGGAGGGAGGCCAGCTGG
7679 CCAGGAGTGTCTACAGCACTCCTCTGGTTACTGAAAGCTCAGGGATAGGGCCTGGCCTT CTCCTTTACCCCTCCTTCCTAGAGAGTTAGA
7680 AAAAGGGATTCAATTGCCATCCATTTAACTGGAATCCGACCCTAAAGAGAAGATGGAA TAAAGACATTGAAGTTACTC
7681 TTGATCATATCTACACCACGCAAAGTGATGTGTAAGTGTGGGTGTTGCTCTCTTGGGGT GGAGGTTACAGAAACACCCTTATACATGTAGTGGGGCCACGACGCCCGTCTGTGCAGC TTGGCCAG
7682 TCTTATTCCTTTAATACAGAATATGGGTAAAGATGATCCGACAAGTGAGAGACAGGAT CAGGTCAGCGGGCTACCACTGGGCC
7683 CAGGTGGTGTTGGGAAAAGCGCACTGACAATCCAGCTAATCCAGAACCACTTTGTAGA TGAATATGATCCCACCATAGAGGTGAGG
7684 GCTCCAACCACCACCAGTTTGTACTCAGTCATTTCACACCAGCAAGAACCTGTTGGAAA CCAGTAATCAGGGTTAATTGGCGAGCCACATCTACAGTACTTTAAAGCTTTCTATAATC
A
7685 AAGAAGAGTACAGTGCCATGAGAGACCAATACATGAGGACAGGCGAAGGCTTCCTCTG
TGTATTTGCCAT
7686 GTACTCTTCTTGTCCAGCTGTATCCAGTATGTCCAACAAACAGGTTTCACCATCTATAAC CACTTGTTTTCTGTAAGAATCCTGGGGGTGT
7687 CTTGGCAATAGCATTGCATTCCCTGTGGTTTTTAATAAAAATTGAACTTCCCTCCCTCCC TGCCCCCTTACCCTCCA
7688 GGTTAAATAAGCATCTAACTATTCAAGCCCATTTCTGCCTATCTGGTTTGTCCCTCAAAT
TGCTAATATATAATCACAAACAAAAAGTATCCAATATCACCCTACATAAAAGAAAACC
C
7689 GGGCTTTCTTTGTGTATTTGCCATAAATAATACTAAATCATTTGAAGATATTCACCATTA
TAGGTGGGTTTAAATTGAATATAATAAGCTGACATTAAGGAGTAATTATAGTTTTTATT
TTTTGAG
7690 CCTCCCCAGTCCTCATGTACTGGTCCCTCATTGCACTGTACTCCTCTTGACCTGCTGTGT CGAGAATATCCAAGAGACAGGT
7691
GCACTGTAATAATCCAGACTGTGTTTCTCCCTTCTCAGGATTCCTACAGGAAGCAAGTA GTAATTGATGGAGAAA
7692 GCTTGTTGCTTGCCAGCCCAGGACTTGGAGGCTCCAGGGGACCCCCATCGTGGGGCCTG GTGGGCAAAGAGGGCTCCAGCCAACCCCCCAAAT
7693 CTACAAGGAGCGGCCGCAGGATGTGGACCAACGTGAGGCTCCCCTCAACAACTTCTCT GTGGCGCGTAAGTATCCCCTTGGCCTCTCGGGATTCAGATTTGGGGGGTTGGCTGGAGC
cc
7694 GCCAATGAAGGTGCCATCATTCTTGAGGAGGAAGTAGCGTGGCCGCCAGGTCTTGATG
TACTCCCCTACAGACGTGCGGGTGGTGAGAGCCACGCACACTCTACCCGTCAGACCCTC
GCCAGGCAGCCAGG
7695
AAAATTAGAACAGTAGATGCTTAGTTTA
7696 TTTCATGCCTTTGGCTACTTGAAGACCAAAGCCAATAAGATCTTTTACAGTTGGATTCT GCAGTCAAAGAGAGTTAGAAAAGCAT
7697 ATATCTTGCAAGCAAAAAGTTTGTCCACAGAGACTTGGCTGCAAGAAACTGTATGTAA GTATCAGAATCTCTGTGCCACAATCCAAATTAAGTGACAAGGAGGAATCTG
7698 AAGTAGTAATAACAGTGCTGTTGATATTGAGACAACACCAGCAATCAATCCTGTGAAA TTCTGATCTGGTTGAA
7699 TTGGGTTTTTCCTGTGGCTGAAAAAGAGAAAGCAAATTAAAGGTGCATTTTTGTTACTG
TTCATTTTTAGAAGTTA
7700 GGTTTTATGGACTACATATAAGACAGCACACAAGAATCGACGACAATCTTAAACTGTA ATGACTGTGTTCTTAAGGTA
7701 ATAAAACCCATGAGTTCTGGGCACTGGGTCAAAGTCTCCTGGGGCCCATGATAGCCGTC TTTAACAAGCTCTTT
7702 CTTCGGGCACTTACAAGCCTATCCAAATGAGGAGTGTGTACTCTTGCATCGTAGCGAAC TAATTCACTGCCCAGATCTTAAAACAGAGAGAAAGA
7703 GTGTAAGCCCAACTACAGAAATGGTTTCAAATGAATCTGTAGACTACCGAGCTACTTTT CCAGAAGGTATATTTCAGTTTATTGTTCTGAGAAATACCTATACAT
7704 GCAGCAGCGAAAGCACCTTGAGGCCTTTCTTACCCAGAGATAGAAGGTGGGAGAACTA AAGGATGACGACTTTGAGAAGATCAGTGAGCTGGGGGCTGGCAATGGCGGTGTGGTGT CCAAA
7705 TATGTGATCAAGAAATTGATAGCATTTGCAGTATAGAGCGTGCAGATAATGACAAGGA GTATCTAGTACTTACTTTAACAAAAAATGATCTTGACAAAGCAAATAAAGACAA
7706
7707 GATGGGAGGACAAGTTCATGTATTTTGAGTTCCCTCAGCCGTTACCTGTGTGTGGTGAT ATCAAAGTAGAGTTCTTCCACAAACAGAACAAGATGCTAAAAAAGGACAAAATGTTTC ACTTTTGGGTA
7708 TTTGAAACTATTCCAATGTTCAGTGGCGGAACTTGCAATCCTCAGTTTGTGGTCTGCCA GCTAAAGGTGAAGATGTATTCCTCCAATTCAGGACCCACACGATGGGAGGACAAGTTC ATGTATTTTGAGTTCCCTCAGCCGTTACCTGTGTGTGGTGATATCAAAGTAGAGTTCT
7709 ACATCATCTTGTGAAACAACAGTGCCACTGGTCTATAATCCACATGATTCTTTACCAGG GTCCTTACTTCCCCATAGAAATCTAGGGCCTCTTGTGCCTTTAAAAATT
7710 AAGTGAAGATGACAATCATGTTGCAGCAATTCACTGTAAAGCTGGAAAGGGACGAACT GGTATAATGATTTATGCATATTTATTACATCGGGGCAA
7711 CGGTCCAGAGCCAAGCAGCGGCTGAGCGAGGGGCATCAGCTACCGCCAAGTCCAGAGC CATTTCCATCCTGCAGAGCCCCGCCACCAG
7712 CTGGTGGCGTAAGCAAAAGTGTCTTGACGATACAGCTAATTCAGAATCATTTTGTGGAC CAATATGATCCAACAATAGAGAATTCCTACAGGAAGCAAGTAGTAATTGATGGAGAAA
7713 CCCCCCCCCCCCCCCGCCCAGTCCTCATGTACTGGTCCTCATTGCATTGTACTCTTCTTG ACCTGTTGTGTCAAGAATATCCAAGAGACAGGT
References
Bang Y, Kwak EL, Shaw AT, Camidge DR, Iafrate AJ, Maki RG, Solomon BJ, Ou R, Salgia R, Clark JW. Activity of the oral ALK inhibitor PF-02341066 in ALK- positive patients with non-small cell lung cancer (NSCLC). J Clin Oncol 28: 18s (suppl; abstr 3), 2010.
Butrynski JE, DAdamo DR, Hornick JL, Dal Cin P, Antonescu CR, Jhanwar SC, Ladanyi M, Capelletti M, Rodig SJ, Ramaiya N, Kwak EL, Clark JW, Wilner KD, Christensen JG, Janne PA, Maki RG, Demetri GD, Shapiro GI. Crizotinib in ALK- rearranged inflammatory myofibroblastic tumor. N Engl J Med. 2010 Oct 28;363(18): 1727-33.
Camidge DR, Doebele RC.Treating ALK-positive lung cancer-early successes and future challenges. Nat Rev Clin Oncol. 2012 Apr 3;9(5):268-77.
Cheng M, Ott GR. Anaplastic lymphoma kinase as a therapeutic target in anaplastic large cell lymphoma, non-small cell lung cancer and neuroblastoma. Anticancer Agents Med Chem 10: 236-249, 2010.
Choi YL, Soda M, Yamashita Y, Ueno T, Takashima J, Nakajima T, Yatabe Y, Takeuchi K, Hamada T, Haruta H, Ishikawa Y, Kimura H, Mitsudomi T, Tanio Y, Mano H; ALK Lung Cancer Study Group. EML4-ALK mutations in lung cancer that confer resistance to ALK inhibitors. N Engl J Med. 2010 Oct 28;363(18): 1734- 9.
Choi YL, Soda M, Yamashita Y, Ueno T, Takashima J, Nakajima T, Yatabe Y, Takeuchi K, Hamada T, Haruta H, Ishikawa Y, Kimura H, Mitsudomi T, Tanio Y, Mano H. ALK Lung Cancer Study Group. EML4-ALK mutations in lung cancer that confer resistance to ALK inhibitors. N Engl J Med. 2010 Oct 28;363(18): 1734- 9.
Christensen JG, Zou HY, Arango ME, Li Q, Lee JH, McDonnell SR, Yamazaki S, Alton GR, Mroczkowski B, Los G. Cytoreductive antitumor activity of PF-2341066, a novel inhibitor of anaplastic lymphoma kinase and c-Met, in experimental models of anaplastic large-cell lymphoma. Mol Cancer Ther 6 (12, Pt. 1): 3314-3322, 2007. Cui JJ et al. Structure based drug design for the discovery of clinical candidate PF- 2341066 as potent and highly selective c-Met inhibitor. Abstracts of Papers, 235th ACS National Meeting, New Orleans, LA, United States, April 6-10, 2008, 2008: p. MEDI-177.
Doebele RC, Pilling AB, Aisner DL, Kutateladze TG, Le AT, Weickhardt AJ, Kondo KL, Linderman DJ, Heasley LE, Franklin WA, Varella-Garcia M, Camidge DR. Mechanisms of resistance to crizotinib in patients with ALK gene rearranged non-small cell lung cancer. Clin Cancer Res. 2012 Mar 1; 18(5): 1472-82.
Doebele RC, Pilling AB, Aisner DL, Kutateladze TG, Le AT, Weickhardt AJ, Kondo KL, Linderman DJ, Heasley LE, Franklin WA, Varella-Garcia M, Camidge
DR. Mechanisms of resistance to crizotinib in patients with ALK gene rearranged non-small cell lung cancer. Clin Cancer Res. 2012 Mar 1; 18(5): 1472-82. Epub 2012 Jan 10.
11. Engelman JA, Zejnullahu K, Mitsudomi T, Song Y, Hyland C, Park JO, Lindeman N, Gale CM, Zhao X, Christensen J, Kosaka T, Holmes AJ, Rogers AM, Cappuzzo
F, Mok T, Lee C, Johnson BE, Cantley LC, Janne PA. Science. 2007 May 18;316(5827): 1039-43. Epub 2007 Apr 26.
12. Hallberg B, Palmer RH. Crizotinib— latest champion in the cancer wars? N Engl J Med 363 : 1760-1762, 2010.
13. Koivunen JP, Mermel C, Zejnullahu K, Murphy C, Lifshits E, Holmes AJ, Choi HG, Kim J, Chiang D, Thomas R, Lee J, Richards WG, Sugarbaker DJ, Ducko C, Lindeman N, Marcoux JP, Engelman JA, Gray NS, Lee C, Meyerson M, Janne PA. EML4-ALK fusion gene and efficacy of an ALK kinase inhibitor in lung cancer. Clin Cancer Res 14: 4275-4283, 2008.
14. Lovly CM, Pao. Escaping ALK inhibition: mechanisms of and strategies to overcome resistance. W. Sci Transl Med. 2012 Feb 8;4(120): 120ps2.
15. McDermott U, lafrate AJ, Gray NS, Shioda T, Classon M, Maheswaran S, Zhou W, Choi HG, Smith SL, Dowell L, Ulkus LE, Kuhlmann G, Greninger P, Christensen JG, Haber DA, Settleman J. Genomic alterations of anaplastic lymphoma kinase may sensitize tumors to anaplastic lymphoma kinase inhibitors. Cancer Res 68:
3389-3395, 2008.
16. Sasaki T, Okuda K, Zheng W, Butrynski J, Capelletti M, Wang L, Gray NS, Wilner K, Christensen JG, Demetri G, Shapiro GI, Rodig SJ, Eck MJ, Janne PA. The neuroblastoma associated F 1174L ALK mutation causes resistance to an ALK kinase inhibitor in ALK translocated cancers. Cancer Res. 2010 Dec
15;70(24): 10038-43.
17. Sasaki T, Rodig SJ, Chirieac LR, Janne PA. The biology and treatment of EML4- ALK non-small cell lung cancer. Eur J Cancer 46: 1773-1780, 2010.
18. Shaw AT, Yeap BY, Mino-Kenudson M, Digumarthy SR, Costa DB, Heist RS, Solomon B, Stubbs H, Admane S, McDermott U, Settleman J, Kobayashi S, Mark
EJ, Rodig SJ, Chirieac LR, Kwak EL, Lynch TJ, lafrate AJ. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol 27: 4247-4253, 2009.
19. Wood AC, Laudenslager M, Haglund EA, Attiyeh EF, Pawel B, Courtright J, Plegaria J, Christensen JG, Mosse YP. Inhibition of ALK mutated neuroblastomas by the selective inhibitor PF-02341066. J Clin Oncol 27: 15s, 2009 (suppl; abstr 10008b).
0. Zou HY, Li Q, Lee JH, Arango ME, McDonnell SR, Yamazaki S, Koudrakova TB, Alton G, Cui JJ, Kung PP, Nambu MD, Los G, Bender SL, Mroczkowski B, Christensen JG. An orally available small-molecule inhibitor of c-Met, PF-2341066,
exhibits cytoreductive antitumor efficacy through antiproliferative and antiangiogenic mechanisms. Cancer Res 67: 4408-4417, 2007.
SEQUENCES
anaplastic lymphoma kinase (ALK) SEQ ID NO: 7714
1 mgaigllwllplllstaavgsgmgtgqragspaagpplqpreplsysrlqrkslavdfvv
61 pslfrvyardlllppssselkagrpeargslaldcapllrllgpapgvswtagspapaea
121 rtlsrvlkggsvrklrrakqlvlelgeeailegcvgppgeaavgllqfniseifswwirq
181 gegrlrirlmpekkasevgregrlsaairasqpr11fqifgtghsslesptnmpspspdy
241 ftwnltwimkdsfpflshrsryglecsfdfpceleyspplhdlrnqswswrripseeasq
301 mdlldgpgaerskemprgsflllntsadskhtilspwmrsssehctlavsvhrhlqpsgr
361 yiaqllphneaareillmptpgkhgwtvlqgrigrpdnpfrvaleyissgnrslsavdff
421 alkncsegtspgskmalqssftcwngtvlqlgqacdfhqdcaqgedesqmcrklpvgfyc
481 nfedgfcgwtqgtlsphtpqwqvrtlkdarfqdhqdhalllsttdvpasesatvtsatfp
541 apiksspcelrmswlirgvlrgnvslvlvenktgkeqgrmvwhvaayeglslwqwmvlpl
601 ldvsdrfwlqmvawwgqgsraivafdnisisldcyltisgedkilqntapksrnlfernp
661 nkelkpgensprqtpifdptvhwlfttcgasgphgptqaqcnnayqnsnlsvevgsegpl
721 kgiqiwkvpatdtysisgygaaggkggkntmmrshgvsvlgifnlekddmlyilvgqqge
781 dacpstnqliqkvcigennvieeeirvnrsvhewaggggggggatyvfkmkdgvpvplii
841 aaggggraygaktdtfhperlennssvlglngnsgaagggggwndntsllwagkslqega
901 tgghscpqamkkwgwetrggfggggggcssggggggyiggnaasnndpemdgedgvsfis
961 plgilytpalkvmeghgevnikhylncshcevdechmdpeshkvicfcdhgtvlaedgvs
1021 civsptpephlplslilsvvtsalvaalvlafsgimivyrrkhqelqamqmelqspeykl
1081 skirtstimtdynpnycfagktssisdlkevprknitlirglghgafgevyegqvsgmpn
1141 dpsplqvavktlpevcseqdeldfImealiiskfnhqnivrcigvslqslprfillelma
1201 ggdlksflretrprpsqpssiamldllhvardiacgcqyleenhfihrdiaarnclltcp
1261 gpgrvakigdfgmardiyrasyyrkggcamlpvkwmppeafmegiftsktdtwsfgvllw
1321 eifslgympypsksnqevlefvtsggrmdppkncpgpvyrimtqcwqhqpedrpnfaiil
1381 erieyctqdpdvintalpieygplveeeekvpvrpkdpegvppllvsqqakreeerspaa
1441 ppplpttssgkaakkptaaeisvrvprgpavegghvnmafsqsnppselhkvhgsrnkpt
1501 slwnptygswftekptkknnpiakkephdrgnlglegsctvppnvatgrlpgasllleps
1561 sltanmkevplfrlrhfpcgnvnygyqqqglpleaatapgaghyedtilksknsmnqpgp
ALK cDNA Sequence Reference SEQ ID NO: 7715
atgggagccatcgggctcctgtggctcctgccgctgctgctttccacggcagctgtgggc
tccgggatggggaccggccagcgcgcgggctccccagctgcggggccgccgctgcagccc
cgggagccactcagctactcgcgcctgcagaggaagagtctggcagttgacttcgtggtg
ccctcgctcttccgtgtctacgcccgggacctactgctgccaccatcctcctcggagctg
aaggctggcaggcccgaggcccgcggctcgctagctctggactgcgccccgctgctcagg
ttgctggggccggcgccgggggtctcctggaccgccggttcaccagccccggcagaggcc
cggacgctgtccagggtgctgaagggcggctccgtgcgcaagctccggcgtgccaagcag
ttggtgctggagctgggcgaggaggcgatcttggagggttgcgtcgggccccccggggag
gcggctgtggggctgctccagttcaatctcagcgagctgttcagttggtggattcgccaa
ggcgaagggcgactgaggatccgcctgatgcccgagaagaaggcgtcggaagtgggcaga
gagggaaggctgtccgcggcaattcgcgcctcccagccccgccttctcttccagatcttc
gggactggtcatagctccttggaatcaccaacaaacatgccttctccttctcctgattat tttacatggaatctcacctggataatgaaagactccttccctttcctgtctcatcgcagc cgatatggtctggagtgcagctttgacttcccctgtgagctggagtattcccctccactg catgacctcaggaaccagagctggtcctggcgccgcatcccctccgaggaggcctcccag atggacttgctggatgggcctggggcagagcgttctaaggagatgcccagaggctccttt ctccttctcaacacctcagctgactccaagcacaccatcctgagtccgtggatgaggagc agcagtgagcactgcacactggccgtctcggtgcacaggcacctgcagccctctggaagg tacattgcccagctgctgccccacaacgaggctgcaagagagatcctcctgatgcccact ccagggaagcatggttggacagtgctccagggaagaatcgggcgtccagacaacccattt cgagtggccctggaatacatctccagtggaaaccgcagcttgtctgcagtggacttcttt gccctgaagaactgcagtgaaggaacatccccaggctccaagatggccctgcagagctcc ttcacttgttggaatgggacagtcctccagcttgggcaggcctgtgacttccaccaggac tgtgcccagggagaagatgagagccagatgtgccggaaactgcctgtgggtttttactgc aactttgaagatggcttctgtggctggacccaaggcacactgtcaccccacactcctcaa tggcaggtcaggaccctaaaggatgcccggttccaggaccaccaagaccatgctctattg ctcagtaccactgatgtccccgcttctgaaagtgctacagtgaccagtgctacgtttcct gcaccgatcaagagctctccatgtgagctccgaatgtcctggctcattcgtggagtcttg aggggaaacgtgtccttggtgctagtggagaacaaaaccgggaaggagcaaggcaggatg gtctggcatgtcgccgcctatgaaggcttgagcctgtggcagtggatggtgttgcctctc ctcgatgtgtctgacaggttctggctgcagatggtcgcatggtggggacaaggatccaga gccatcgtggcttttgacaatatctccatcagcctggactgctacctcaccattagcgga gaggacaagatcctgcagaatacagcacccaaatcaagaaacctgtttgagagaaaccca aacaaggagctgaaacccggggaaaattcaccaagacagacccccatctttgaccctaca gttcattggctgttcaecacatgtggggccagcgggccccatggccccacccaggcacag tgcaacaacgcctaccagaactccaacctgagcgtggaggtggggagcgagggccccctg aaaggcatccagatctggaaggtgccagccaccgacacctacagcatctcgggctacgga gctgctggcgggaaaggcgggaagaacaccatgatgcggtcccacggcgtgtctgtgctg ggcatcttcaacctggagaaggatgacatgctgtacatcctggttgggcagcagggagag gacgcctgccccagtacaaaccagttaatccagaaagtctgcattggagagaacaatgtg atagaagaagaaatccgtgtgaacagaagcgtgcatgagtgggcaggaggcggaggagga gggggtggagccacctacgtatttaagatgaaggatggagtgccggtgcccctgatcatt gcagccggaggtggtggcagggcctacggggccaagacagacacgttccacccagagaga ctggagaataactcctcggttctagggctaaacggcaattccggagccgcaggtggtgga ggtggctggaatgataacacttccttgctctgggccggaaaatctttgcaggagggtgcc accggaggacattcctgcccccaggccatgaagaagtgggggtgggagacaagagggggt ttcggagggggtggaggggggtgctcctcaggtggaggaggcggaggatatataggcggc aatgcagcctcaaacaatgaccccgaaatggatggggaagatggggtttccttcatcagt ccactgggcatcctgtacaccccagctttaaaagtgatggaaggccacggggaagtgaat attaagcattatctaaactgcagtcactgtgaggtagacgaatgtcacatggaccctgaa agccacaaggtcatctgcttctgtgaccacgggacggtgctggctgaggatggcgtctcc tgcattgtgtcacccaccccggagccacacctgccactctcgctgatcctctctgtggtg acctctgccctcgtggccgccctggtcctggctttctccggcatcatgattgtgtaccgc cggaagcaccaggagctgcaagccatgcagatggagctgcagagccctgagtacaagctg agcaagctccgcacctcgaccatcatgaccgactacaaccccaactactgctttgctggc aagacctcctccatcagtgacctgaaggaggtgccgcggaaaaacatcaccctcattcgg ggtctgggccatggcgcctttggggaggtgtatgaaggccaggtgtccggaatgcccaac gacccaagccccctgcaagtggctgtgaagacgctgcctgaagtgtgctctgaacaggac gaactggatttcctcatggaagccctgatcatcagcaaattcaaccaccagaacattgtt cgctgcattggggtgagcctgcaatccctgccccggttcatcctgctggagctcatggcg gggggagacctcaagtccttcctccgagagacccgccctcgcccgagccagccctcctcc ctggccatgctggaccttctgcacgtggctcgggacattgcctgtggctgtcagtatttg gaggaaaaccacttcatccaccgagacattgctgccagaaactgcctcttgacctgtcca ggccctggaagagtggccaagattggagacttcgggatggcccgagacatctacagggcg agctactatagaaagggaggctgtgccatgctgccagttaagtggatgcccccagaggcc ttcatggaaggaatattcacttctaaaacagacacatggtcctttggagtgctgctatgg gaaatcttttctcttggatatatgccataccccagcaaaagcaaccaggaagttctggag tttgtcaccagtggaggccggatggacccacccaagaactgccctgggcctgtataccgg
ataatgactcagtgctggcaacatcagcctgaagacaggcccaactttgccatcattttg gagaggattgaatactgcacccaggacccggatgtaatcaacaccgctttgccgatagaa tatggtccacttgtggaagaggaagagaaagtgcctgtgaggcccaaggaccctgagggg gttcctcctctcctggtctctcaacaggcaaaacgggaggaggagcgcagcccagctgcc atctctgttcgagtccctagagggccggccgtggaagggggacacgtgaatatggcattc tctcagtccaaccctccttcggagttgcacaaggtccacggatccagaaacaagcccacc agcttgtggaacccaacgtacggctcctggtttacagagaaacccaccaaaaagaataat cctatagcaaagaaggagccacacgacaggggtaacctggggctggagggaagctgtact gtcccacctaacgttgcaactgggagacttccgggggcctcactgctcctagagccctct tcgctgactgccaatatgaaggaggtacctctgttcaggctacgtcacttcccttgtggg aatgtcaattacggctaccagcaacagggcttgcccttagaagccgctactgcccctgga gctggtcattacgaggataccattctgaaaagcaagaatagcatgaaccagcctgggccc tga
EGFR cDNA Sequence Reference SEQ ID NO: 7716
ATGCGACCCTCCGGGACGGCCGGGGCAGCGCTCCTGGCGCTGCTGGCTGCGCTCTGCCCG GCGAGTCGGGCTCTGGAGGAAAAGAAAGTTTGCCAAGGCACGAGTAACAAGCTCACGCAG TTGGGCACTTTTGAAGATCATTTTCTCAGCCTCCAGAGGATGTTCAATAACTGTGAGGTG GTCCTTGGGAATTTGGAAATTACCTATGTGCAGAGGAATTATGATCTTTCCTTCTTAAAG ACCATCCAGGAGGTGGCTGGTTATGTCCTCATTGCCCTCAACACAGTGGAGCGAATTCCT TTGGAAAACCTGCAGATCATCAGAGGAAATATGTACTACGAAAATTCCTATGCCTTAGCA GTCTTATCTAACTATGATGCAAATAAAACCGGACTGAAGGAGCTGCCCATGAGAAATTTA CAGGAAATCCTGCATGGCGCCGTGCGGTTCAGCAACAACCCTGCCCTGTGCAACGTGGAG AGCATCCAGTGGCGGGACATAGTCAGCAGTGACTTTCTCAGCAACATGTCGATGGACTTC CAGAACCACCTGGGCAGCTGCCAAAAGTGTGATCCAAGCTGTCCCAATGGGAGCTGCTGG GGTGCAGGAGAGGAGAACTGCCAGAAACTGACCAAAATCATCTGTGCCCAGCAGTGCTCC GGGCGCTGCCGTGGCAAGTCCCCCAGTGACTGCTGCCACAACCAGTGTGCTGCAGGCTGC ACAGGCCCCCGGGAGAGCGACTGCCTGGTCTGCCGCAAATTCCGAGACGAAGCCACGTGC AAGGACACCTGCCCCCCACTCATGCTCTACAACCCCACCACGTACCAGATGGATGTGAAC CCCGAGGGCAAATACAGCTTTGGTGCCACCTGCGTGAAGAAGTGTCCCCGTAATTATGTG GTGACAGATCACGGCTCGTGCGTCCGAGCCTGTGGGGCCGACAGCTATGAGATGGAGGAA GACGGCGTCCGCAAGTGTAAGAAGTGCGAAGGGCCTTGCCGCAAAGTGTGTAACGGAATA GGTATTGGTGAATTTAAAGACTCACTCTCCATAAATGCTACGAATATTAAACACTTCAAA AACTGCACCTCCATCAGTGGCGATCTCCACATCCTGCCGGTGGCATTTAGGGGTGACTCC TTCACACATACTCCTCCTCTGGATCCACAGGAACTGGATATTCTGAAAACCGTAAAGGAA ATCACAGGGTTTTTGCTGATTCAGGCTTGGCCTGAAAACAGGACGGACCTCCATGCCTTT GAGAACCTAGAAATCATACGCGGCAGGACCAAGCAACATGGTCAGTTTTCTCTTGCAGTC GTCAGCCTGAACATAACATCCTTGGGATTACGCTCCCTCAAGGAGATAAGTGATGGAGAT GTGATAATTTCAGGAAACAAAAATTTGTGCTATGCAAATACAATAAACTGGAAAAAACTG TTTGGGACCTCCGGTCAGAAAACCAAAATTATAAGCAACAGAGGTGAAAACAGCTGCAAG GCCACAGGCCAGGTCTGCCATGCCTTGTGCTCCCCCGAGGGCTGCTGGGGCCCGGAGCCC AGGGACTGCGTCTCTTGCCGGAATGTCAGCCGAGGCAGGGAATGCGTGGACAAGTGCAAC CTTCTGGAGGGTGAGCCAAGGGAGTTTGTGGAGAACTCTGAGTGCATACAGTGCCACCCA GAGTGCCTGCCTCAGGCCATGAACATCACCTGCACAGGACGGGGACCAGACAACTGTATC CAGTGTGCCCACTACATTGACGGCCCCCACTGCGTCAAGACCTGCCCGGCAGGAGTCATG GGAGAAAACAACACCCTGGTCTGGAAGTACGCAGACGCCGGCCATGTGTGCCACCTGTGC CATCCAAACTGCACCTACGGATGCACTGGGCCAGGTCTTGAAGGCTGTCCAACGAATGGG CCTAAGATCCCGTCCATCGCCACTGGGATGGTGGGGGCCCTCCTCTTGCTGCTGGTGGTG GCCCTGGGGATCGGCCTCTTCATGCGAAGGCGCCACATCGTTCGGAAGCGCACGCTGCGG AGGCTGCTGCAGGAGAGGGAGCTTGTGGAGCCTCTTACACCCAGTGGAGAAGCTCCCAAC CAAGCTCTCTTGAGGATCTTGAAGGAAACTGAATTCAAAAAGATCAAAGTGCTGGGCTCC GGTGCGTTCGGCACGGTGTATAAGGGACTCTGGATCCCAGAAGGTGAGAAAGTTAAAATT CCCGTCGCTATCAAGGAATTAAGAGAAGCAACATCTCCGAAAGCCAACAAGGAAATCCTC GATGAAGCCTACGTGATGGCCAGCGTGGACAACCCCCACGTGTGCCGCCTGCTGGGCATC
TGCCTCACCTCCACCGTGCAGCTCATCACGCAGCTCATGCCCTTCGGCTGCCTCCTGGAC TATGTCCGGGAACACAAAGACAATATTGGCTCCCAGTACCTGCTCAACTGGTGTGTGCAG ATCGCAAAGGGCATGAACTACTTGGAGGACCGTCGCTTGGTGCACCGCGACCTGGCAGCC AGGAACGTACTGGTGAAAACACCGCAGCATGTCAAGATCACAGATTTTGGGCTGGCCAAA CTGCTGGGTGCGGAAGAGAAAGAATACCATGCAGAAGGAGGCAAAGTGCCTATCAAGTGG ATGGCATTGGAATCAATTTTACACAGAATCTATACCCACCAGAGTGATGTCTGGAGCTAC GGGGTGACTGTTTGGGAGTTGATGACCTTTGGATCCAAGCCATATGACGGAATCCCTGCC AGCGAGATCTCCTCCATCCTGGAGAAAGGAGAACGCCTCCCTCAGCCACCCATATGTACC ATCGATGTCTACATGATCATGGTCAAGTGCTGGATGATAGACGCAGATAGTCGCCCAAAG TTCCGTGAGTTGATCATCGAATTCTCCAAAATGGCCCGAGACCCCCAGCGCTACCTTGTC ATTCAGGGGGATGAAAGAATGCATTTGCCAAGTCCTACAGACTCCAACTTCTACCGTGCC CTGATGGATGAAGAAGACATGGACGACGTGGTGGATGCCGACGAGTACCTCATCCCACAG CAGGGCTTCTTCAGCAGCCCCTCCACGTCACGGACTCCCCTCCTGAGCTCTCTGAGTGCA ACCAGCAACAATTCCACCGTGGCTTGCATTGATAGAAATGGGCTGCAAAGCTGTCCCATC AAGGAAGACAGCTTCTTGCAGCGATACAGCTCAGACCCCACAGGCGCCTTGACTGAGGAC AGCATAGACGACACCTTCCTCCCAGTGCCTGAATACATAAACCAGTCCGTTCCCAAAAGG CCCGCTGGCTCTGTGCAGAATCCTGTCTATCACAATCAGCCTCTGAACCCCGCGCCCAGC AGAGACCCACACTACCAGGACCCCCACAGCACTGCAGTGGGCAACCCCGAGTATCTCAAC ACTGTCCAGCCCACCTGTGTCAACAGCACATTCGACAGCCCTGCCCACTGGGCCCAGAAA GGCAGCCACCAAATTAGCCTGGACAACCCTGACTACCAGCAGGACTTCTTTCCCAAGGAA GCCAAGCCAAATGGCATCTTTAAGGGCTCCACAGCTGAAAATGCAGAATACCTAAGGGTC GCGCCACAAAGCAGTGAATTTATTGGAGCATGA
BRAF cDNA Sequence Reference SEQ ID NO: 7717
atggcggcgctgagcggtggcggtggtggcggcgcggagccgggccaggctctgttcaac ggggacatggagcccgaggccggcgccggcgccggcgccgcggcctcttcggctgcggac cctgccattccggaggaggtgtggaatatcaaacaaatgattaagttgacacaggaacat atagaggccctattggacaaatttggtggggagcataatccaccatcaatatatctggag gcctatgaagaatacaccagcaagctagatgcactccaacaaagagaacaacagttattg gaatctctggggaacggaactgatttttctgtttctagctctgcatcaatggataccgtt acatcttcttcctcttctagcctttcagtgctaccttcatctctttcagtttttcaaaat cccacagatgtggcacggagcaaccccaagtcaccacaaaaacctatcgttagagtcttc ctgcccaacaaacagaggacagtggtacctgcaaggtgtggagttacagtccgagacagt ctaaagaaagcactgatgatgagaggtctaatcccagagtgctgtgctgtttacagaatt caggatggagagaagaaaccaattggttgggacactgatatttcctggcttactggagaa gaattgcatgtggaagtgttggagaatgttccacttacaacacacaactttgtacgaaaa acgtttttcaccttagcattttgtgacttttgtcgaaagctgcttttccagggtttccgc tgtcaaacatgtggttataaatttcaccagcgttgtagtacagaagttccactgatgtgt gttaattatgaccaacttgatttgctgtttgtctccaagttctttgaacaccacccaata ccacaggaagaggcgtccttagcagagactgccctaacatctggatcatccccttccgca cccgcctcggactctattgggccccaaattctcaccagtccgtctccttcaaaatccatt ccaattccacagcccttccgaccagcagatgaagatcatcgaaatcaatttgggcaacga gaccgatcctcatcagctcccaatgtgcatataaacacaatagaacctgtcaatattgat gacttgattagagaccaaggatttcgtggtgatggaggatcaaccacaggtttgtctgct accccccctgcctcattacctggctcactaactaacgtgaaagccttacagaaatctcca ggacctcagcgagaaaggaagtcatcttcatcctcagaagacaggaatcgaatgaaaaca cttggtagacgggactcgagtgatgattgggagattcctgatgggcagattacagtggga caaagaattggatctggatcatttggaacagtctacaagggaaagtggcatggtgatgtg gcagtgaaaatgttgaatgtgacagcacctacacctcagcagttacaagccttcaaaaat gaagtaggagtactcaggaaaacacgacatgtgaatatcctactcttcatgggctattcc acaaagccacaactggctattgttacccagtggtgtgagggctccagcttgtatcaccat ctccatatcattgagaccaaatttgagatgatcaaacttatagatattgcacgacagact gcacagggcatggattacttacacgccaagtcaatcatccacagagacctcaagagtaat aatatatttcttcatgaagacctcacagtaaaaataggtgattttggtctagctacagtg aaatctcgatggagtgggtcccatcagtttgaacagttgtctggatccattttgtggatg
gcaccagaagtcatcagaatgcaagataaaaatccatacagctttcagtcagatgtatat gcatttggaattgttctgtatgaattgatgactggacagttaccttattcaaacatcaac aacagggaccagataatttttatggtgggacgaggatacctgtctccagatctcagtaag gtacggagtaactgtccaaaagccatgaagagattaatggcagagtgcctcaaaaagaaa ttgccaaaaattcaccgcagtgcatcagaaccctccttgaatcgggctggtttccaaaca gaggattttagtctatatgcttgtgcttctccaaaaacacccatccaggcagggggatat ggtgcgtttcctgtccactga
KRAS cDNA Sequence Reference SEQ ID NO: 7718
atgactgaatataaacttgtggtagttggagctggtggcgtaggcaagagtgccttgacg atacagctaattcagaatcattttgtggacgaatatgatccaacaatagaggattcctac aggaagcaagtagtaattgatggagaaacctgtctcttggatattctcgacacagcaggt caagaggagtacagtgcaatgagggaccagtacatgaggactggggagggctttctttgt gtatttgccataaataatactaaatcatttgaagatattcaecattatagagaacaaatt aaaagagttaaggactctgaagatgtacctatggtcctagtaggaaataaatgtgatttg ccttctagaacagtagacacaaaacaggctcaggacttagcaagaagttatggaattcct tttattgaaacatcagcaaagacaagacagggtgttgatgatgccttctatacattagtt cgagaaattcgaaaacataaagaaaagatgagcaaagatggtaaaaagaagaaaaagaag tcaaagacaaagtgtgtaattatgtaa
Claims
1. A kinase inhibitor resistance panel comprising one or more primer sets from one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
2. The kinase inhibitor resistance panel of claim 1, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS.
3. The kinase inhibitor panel of claim 2, wherein one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of Tables 10 and/or 14.
4. The kinase inhibitor panel of claim 2, wherein one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 4601-5200 and 7181-7610.
5. The kinase inhibitor resistance panel of claim 1, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 18, 19, 20, 21 or 22 oiEGFR.
6. The kinase inhibitor panel of claim 5, wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of Tables 8 and/or 12.
7. The kinase inhibitor panel of claim 6, wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 1641-2440 and 5819-6524.
8. The kinase inhibitor resistance panel of claim 1, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 21, 22, 23, 24, or 25 oiALK.
9. The kinase inhibitor panel of claim 8, wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of Tables 7 and/or 11.
10. The kinase inhibitor panel of claim 9, wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 1-1640 and 5201-5818.
1 1. The kinase inhibitor resistance panel of claim 1, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 8, 9, 10, 11, 12, 13, or 17 of KIT.
12. The kinase inhibitor panel of claim 1 1, wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of Table 9.
13. The kinase inhibitor panel of claim 12, wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 2441-4600.
14. The kinase inhibitor resistance panel of claim 1, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 10, 11, 13, 14, or 15 oiBRAF.
15. The kinase inhibitor panel of claim 14, wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of Table 13.
16. The kinase inhibitor panel of claim 15, wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 6525-7180.
17. The kinase inhibitor panel of claim 1, wherein the panel comprises two or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT.
18. The kinase inhibitor panel of claim 1, wherein the panel comprises 3, 4, 5, 6, 7, 8, 9, 10, or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
19. The kinase inhibitor panel of claim 1, wherein the panel comprises one or more primer sets for 2, 3, 4, of all 5 of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
20. The kinase inhibitor of claim 1, wherein the kinase inhibitor resistance is resistance to an ALK kinase inhibitor.
21. The kinase inhibitor resistance panel of claim 20, wherein the kinase inhibitor is selected from the group consisting of crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib, Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib, Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, and Vemurafenib.
22. The kinase inhibitor resistance panel of claim 21, wherein the kinase inhibitor comprises crizotinib.
23. The kinase inhibitor panel of claim 1, wherein the one or more primer sets amplify one or more mutations associated with kinase inhibitor resistance, wherein the mutation is identified in Table 2, 3, 4, 5, or 6.
24. A method for the detection of kinase inhibitor resistance comprising obtaining a tissue sample from a subject with a cancer and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample using the kinase inhibitor resistant panel of Claim 1, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
25. A method for the detection of kinase inhibitor resistance comprising obtaining a tissue sample from a subject with a cancer and conducting a high throughput sequencing (also known as next generation sequencing) reaction on the sample using one or more primer sets or primer panels with primer sets that specifically hybridizes to one or more of the genes selected from the group consisting oiALK, KRAS, EGFR, KIT, and BRAF, wherein the presence of a mutation in the nucleic acid sequence of a gene associated with kinase inhibitor resistance indicates that that the cancer is resistant or will become resistant to a kinase inhibitor.
26. The method of Claim 25, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 1 or 2 oiKRAS.
27. The method of claim 26, wherein one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of Tables 10 and/or 14.
28. The method of claim 26, wherein one or more KRAS hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 4601-5200 and 7181-7610.
29. The method of claim 25, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 18, 19, 20, 21 or 22 oiEGFR.
30. The method of claim 29, wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of Tables 8 and/or 12.
31. The method of claim 29, wherein one or more EGFR hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 1641-2440 and 5819-6524.
32. The method of claim 25, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 21, 22, 23, 24, or 25 oiALK.
33. The method of claim 32, wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of Tables 7 and/or 1 1.
34. The method of claim 32, wherein one or more ALK hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 1-1640 and 5201-5818.
35. The method of claim 25, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 8, 9, 10, 11, 12, 13, or 17 of KIT.
36. The method of claim 35, wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of Table 9.
37. The method of claim 35, wherein one or more KIT hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 2441-4600.
38. The method of claim 25, wherein at least one primer sets hybridizes and amplifies nucleic acid from exon 10, 11, 13, 14, or 15 oiBRAF.
39. The method of claim 38, wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of Table 13.
40. The method of claim 38, wherein one or more BRAF hybridizing primers or primer sets comprise one or more of the primers of SEQ ID NOs: 6525-7180.
41. The method of claim 25, wherein the panel comprises two or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
42. The method of claim 25, wherein the panel comprises 3, 4, 5, 6, 7, 8, 9, 10, or more primer sets for one or more of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
43. The method of claim 25, wherein the panel comprises one or more primer sets for 2, 3, 4, of all 5 of the genes selected from group of genes comprising KRAS, BRAF, EGFR, ALK, and KIT
44. The method of claim 25, wherein the kinase inhibitor resistance is resistance to an ALK kinase inhibitor.
45. The method of claim 25, wherein the kinase inhibitor is selected from the group consisting of crizotinib, afatinib, Axitinib, bevacizumab, Bosutinib, Cetuximab, Dasatinib,
Erlotinib, Fostamati nib, Gefitinib, Imatinib, Lapatinib, Lenvatinib, Nilotinib,
Panitumumab, Pazopanib, Pegaptanib, Ranibizumab, Ruxolitinib, Sorafenib, Sunitinib, Trastuzumab, and Vemurafenib.
46. The method of claim 45, wherein the kinase inhibitor comprises crizotinib.
47. The method of claim 25, wherein the one or more primer sets amplify one or more mutations associated with kinase inhibitor resistance, wherein the mutation is identified in Table 2, 3, 4, 5, or 6.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2886397 CA2886397A1 (en) | 2012-09-26 | 2013-09-26 | Methods and compositions relating to next generation sequencing for genetic testing in alk related cancers |
| US14/431,430 US20150240301A1 (en) | 2012-10-05 | 2013-09-26 | Methods and compositions relating to next generation sequencing for genetic testing in alk related cancers |
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| US201261705825P | 2012-09-26 | 2012-09-26 | |
| US61/705,825 | 2012-09-26 | ||
| US201261710455P | 2012-10-05 | 2012-10-05 | |
| US61/710,455 | 2012-10-05 |
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| WO2014052613A3 WO2014052613A3 (en) | 2014-06-12 |
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| PCT/US2013/061950 Ceased WO2014052613A2 (en) | 2012-09-26 | 2013-09-26 | Methods and compositions relating to next generation sequencing for genetic testing in alk related cancers |
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Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2016008853A1 (en) * | 2014-07-14 | 2016-01-21 | Universität Zürich Prorektorat Mnw | Means and methods for identifying a patient having a braf-positive cancer as a non-responder to a braf inhibitor and as a responder to an mapk/erk inhibitor |
| CN111793675A (en) * | 2019-12-11 | 2020-10-20 | 杭州迪安医学检验中心有限公司 | Nucleic acid sequence for detecting EGFR gene 18 exon G719X mutation, kit and application thereof |
| US11040027B2 (en) | 2017-01-17 | 2021-06-22 | Heparegenix Gmbh | Protein kinase inhibitors for promoting liver regeneration or reducing or preventing hepatocyte death |
| US11136584B2 (en) * | 2015-11-04 | 2021-10-05 | Duke University | Splice-switching oligonucleotides and methods of use |
| WO2022226291A1 (en) * | 2021-04-22 | 2022-10-27 | Dana-Farber Cancer Institute, Inc. | Compositions and methods for treating cancer |
| CN115704802A (en) * | 2021-08-11 | 2023-02-17 | 北京蛋白质组研究中心 | Application of serum protein in screening and diagnosing novel coronavirus pneumonia |
| CN117844933A (en) * | 2024-03-07 | 2024-04-09 | 上海复迪生生命科学有限公司 | Multiplex PCR primer group for detecting lung tumor related gene variation and application thereof |
Family Cites Families (7)
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| GB9422814D0 (en) * | 1994-11-11 | 1995-01-04 | Medinnova Sf | Chemical method |
| WO2007001868A1 (en) * | 2005-06-28 | 2007-01-04 | Genentech, Inc. | Egfr and kras mutations |
| EP2118322A2 (en) * | 2007-03-13 | 2009-11-18 | Amgen Inc. | K-ras and b-raf mutations and anti-egfr antibody therapy |
| CN101381779B (en) * | 2008-10-21 | 2011-06-08 | 广州益善生物技术有限公司 | Detection probe of kRas gene mutation, liquid phase chip and detection method thereof |
| EP2496257A4 (en) * | 2009-11-05 | 2013-02-27 | Cephalon Australia Pty Ltd | Treatment of cancer involving mutated kras or braf genes |
| EP2499486A4 (en) * | 2009-11-13 | 2013-11-27 | Infinity Pharmaceuticals Inc | Compositions, kits, and methods for identification, assessment, prevention, and therapy of cancer |
| WO2011104695A2 (en) * | 2010-02-26 | 2011-09-01 | GAMMAGENETICS Sàrl | Detection of kras mutation in exon 2 by allele specific real time quantitative pcr (as-qpcr) |
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2013
- 2013-09-26 CA CA 2886397 patent/CA2886397A1/en not_active Abandoned
- 2013-09-26 WO PCT/US2013/061950 patent/WO2014052613A2/en not_active Ceased
Cited By (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2016008853A1 (en) * | 2014-07-14 | 2016-01-21 | Universität Zürich Prorektorat Mnw | Means and methods for identifying a patient having a braf-positive cancer as a non-responder to a braf inhibitor and as a responder to an mapk/erk inhibitor |
| EP3169797B1 (en) | 2014-07-14 | 2019-08-21 | Universität Zürich Prorektorat MNW | Means and methods for identifying a patient having a braf-positive cancer as a non-responder to a braf inhibitor and as a responder to an mapk/erk inhibitor |
| US11136584B2 (en) * | 2015-11-04 | 2021-10-05 | Duke University | Splice-switching oligonucleotides and methods of use |
| US12071626B2 (en) | 2015-11-04 | 2024-08-27 | Duke University | Splice-switching oligonucleotides and methods of use |
| US11040027B2 (en) | 2017-01-17 | 2021-06-22 | Heparegenix Gmbh | Protein kinase inhibitors for promoting liver regeneration or reducing or preventing hepatocyte death |
| CN111793675A (en) * | 2019-12-11 | 2020-10-20 | 杭州迪安医学检验中心有限公司 | Nucleic acid sequence for detecting EGFR gene 18 exon G719X mutation, kit and application thereof |
| CN111793675B (en) * | 2019-12-11 | 2023-05-23 | 杭州迪安医学检验中心有限公司 | Nucleic acid sequence for EGFR gene 18 exon G719X mutation detection, kit and application thereof |
| WO2022226291A1 (en) * | 2021-04-22 | 2022-10-27 | Dana-Farber Cancer Institute, Inc. | Compositions and methods for treating cancer |
| CN115704802A (en) * | 2021-08-11 | 2023-02-17 | 北京蛋白质组研究中心 | Application of serum protein in screening and diagnosing novel coronavirus pneumonia |
| CN117844933A (en) * | 2024-03-07 | 2024-04-09 | 上海复迪生生命科学有限公司 | Multiplex PCR primer group for detecting lung tumor related gene variation and application thereof |
| CN117844933B (en) * | 2024-03-07 | 2024-06-11 | 上海复迪生生命科学有限公司 | Multiplex PCR primer group for detecting lung tumor related gene variation and application thereof |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2014052613A3 (en) | 2014-06-12 |
| CA2886397A1 (en) | 2014-04-03 |
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