Analytical Validation of the Labcorp Plasma Complete Test, a Cell-Free DNA Comprehensive Genomic Profiling Tool for Precision Oncology.

Abstract

To help guide treatment decisions and clinical trial matching, tumor genomic profiling is an essential precision oncology tool. Liquid biopsy, a complementary approach to tissue testing, can assess tumor-specific DNA alterations circulating in the blood. Labcorp Plasma Complete is a next-generation sequencing, cell-free DNA comprehensive genomic profiling test that identifies clinically relevant somatic variants across 521 genes in advanced and metastatic solid cancers. Over 800 unique sequencing libraries across 27 cancer types were evaluated to establish analytical sensitivity, specificity, accuracy, and precision, reproducibility, and repeatability. Sensitivity was verified for each variant type, with a median variant allele frequency (VAF) of 1.25% and 1.27% for panel-wide single-nucleotide variants and insertions/deletions (sequence variants), respectively, with <1% VAF sensitivity observed for clinically actionable variants, 1.72-fold for copy number amplifications, 0.48% fusion read fraction for translocations, and 0.47% sequence mutation VAF for microsatellite instability-high. Analytical specificity was 99.9999% for single-nucleotide variants and 100% for all other variant types. Precision, reproducibility, and repeatability resulted in 94.9% average positive agreement and 99.9% average negative agreement for sequence variants and 100% average positive agreement and average negative agreement for copy number amplifications, translocations, and microsatellite instability. Orthogonal assays were used to assess accuracy, demonstrating an aggregate analytical concordance of 97.4% positive percentage agreement and >99.99997% negative percentage agreement for all variants. Overall, the test demonstrates high sensitivity, specificity, accuracy, and robustness to enable informed clinical decision-making.