Ultra-short circulating tumor dna (UsctDNA) in plasma and saliva of non-small cell lung cancer (NSCLC) patients

Feng Li, Fang Wei, Wei Lun Huang, Chien Chung Lin, Liang Li, Macy M. Shen, Qingxiang Yan, Wei Liao, David Chia, Michael Tu, Jason H. Tang, Ziding Feng, Yong Kim, Wu Chou Su, David T.W. Wong

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Mutations identified in the epidermal growth factor receptor (EGFR) predict sensitivity to EGFR-targeted therapy for non-small cell lung carcinoma (NSCLC). We previously reported that Electric Field-Induced Release and Measurement (EFIRM)-based liquid biopsy could detect EGFR ctDNA with >94% concordance with tissue-based genotyping. A side-by-side comparison of concordance of EFIRM and droplet digital PCR (ddPCR) for the detection of the two front-line actionable EFGR mutations was performed with paired plasma and saliva samples from 13 NSCLC patients. Deep sequencing analysis based on single-strand DNA library preparation was employed to determine the size distributions of EGFR L858R ctDNA in plasma and saliva samples. EFIRM detected both EGFR mutations with 100% sensitivity in both plasma and saliva samples, whereas ddPCR detected EGFR mutations with sensitivities of 84.6% and 15.4%, respectively. In saliva samples, the majority of EGFR L858R ctDNA fragments detected were <80 bp. Deep sequencing analysis of ctDNA enriched for the EGFR L858R mutation revealed the significant presence of EGFR L858R ctDNA as ultra-short circulating tumor DNA (usctDNA) with the size of 40–60 bp in patient plasma and saliva. Most of usctDNAs are not amplifiable with the current ddPCR assay. Further examination using cell lines and patient biofluids revealed that the majority of usctDNAs were predominately localized in the exosomal fraction. Our study revealed the abundant existence of EGFR ctDNA in the plasma and saliva of NSCLC patients is usctDNA. usctDNA is a novel type of targets for liquid biopsy that can be efficiently detected by EFIRM technology.

Original languageEnglish
Article number2041
Pages (from-to)1-15
Number of pages15
Issue number8
Publication statusPublished - 2020 Aug

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


Dive into the research topics of 'Ultra-short circulating tumor dna (UsctDNA) in plasma and saliva of non-small cell lung cancer (NSCLC) patients'. Together they form a unique fingerprint.

Cite this