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. 2023 Sep 11;11(9):e006013. doi: 10.1136/jitc-2022-006013

Table 1. Current cell-free DNA-based approaches for the detection of cancer.

Approach Methodology Relative abundance of target signals Assay Number of targets Performance Cohort size Tumor informed Extent of clinical evaluation Relative cost of approach References
Mutation analysis Capture-based targeted, multiplex PCR, genome-wide or whole-exome next generation sequencing Few to hundreds of known mutations or genome-wide Elio Plasma Resolve 33 VAF≥95% LoD 0.1%–0.5% n=75 No Clinical validity, case–control, prospective cohort $$$–$$$$ 32
FoundationOne Liquid 324 VAF≥95% LoD 0.4% n>30 cancer types No 12
Guardant360 74 VAF>80%LoD 0.25% n>1500 No 34
MRDetect Genome-wide VAF LoD 10−5, >85% at 20×, >99% at 50× n=98 Yes 73
Signatera 16 VAF>95% LoD 0.01% n=49 Yes 35 36
CancerSeek (DETECT-A) 16 Specificity: 98.9% Sensitivity: 27% n=9,911 No 26
RaDaR 48 VAF=95% LoD 0.001% n=88, n=17 Yes 37 38
DNA methylation profiling Bisulfite conversion- sequencing or DNA methylation immunoprecipitation-sequencing Thousands to tens of thousands of CpG methylation differences Galleri (PATHFINDER) Targeted methylation Specificity: 99.1% Sensitivity: 29% n=6,621 No Clinical validity, case–control, prospective cohort $$$–$$$$ 81
cfMeDIP-seq Anti-5mc Lung AUC: 0.971AML AUC: 0.98PDAC AUC: 0.92 n=388 No 24 59
Fragmentation profiling Low-coverage whole-genome, next-generation sequencing Millions of fragmentation differences DELFI Genome-wide AUC: 0.86 - 0.98 across cancer types n=423 No Proof-of-concept, clinical validity, case–control, prospective-retrospective cohort $–$$ 61 63
End Motifs Motif diversity score AUC 0.86 n=89 No 70
GALYFRE Genome-wide Specificity: 95%Sensitivity: 66.9% n=661 No 71
Mutational signatures GEMINI Genome-wide AUC 0.90 n=109 No 41
Pointy Genome-wide AUC 0.96 n=405 No 42

AMLacute myeloid leukemiaAUCarea under the curveLoDlimit of detectionPDACpancreatic ductal adenocarcinomaVAFvariant allele fraction