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  5. EXaCT-2: an augmented and customizable oncology-focused whole exome sequencing platform

EXaCT-2: an augmented and customizable oncology-focused whole exome sequencing platform

File(s)
42014463.pdf (3.24 MB)
Permanent Link(s)
https://hdl.handle.net/1813/126878
Collections
Department of Medicine
Author
Waltman, Peter
Chandra, Pooja
Eng, Ken W.
Wilkes, David C.
Park, Hyeon
Pabon, Carlos
Delpe, Princesca
Bhinder, Bhavneet
Manohar, Jyothi
Kane, Troy
Fernandez, Evan
Gorski, Kathryn
Greco, Noah
Simi, Manuele
Tang, Jeffrey M.
Zisimopoulos, Pantelis
King, Abigail
Al Assaad, Majd
Ten Eyck, Theresa
Roberts, Douglas
Monge, Jorge
Demichelis, Francesca
Tam, Wayne
Ouseph, Madhu M.
Sigaras, Alexandros
Beltran, Himisha
Rennert, Hannah
Lindeman, Neal
Song, Wei
Solomon, James
Mosquera, Juan Miguel
Kim, Rob
Catalano, Jeffrey
Hassane, Duane C.
Sigouros, Michael
Elemento, Olivier
Alonso, Alicia
Sboner, Andrea
Abstract

We developed and benchmarked Exome Cancer Test v.2.0 (EXaCT-2), a novel whole-exome sequencing (WES) assay based on Agilent’s SureSelect hybrid-capture technology and expanded with custom probes targeting cancer-informative genomic regions. EXaCT-2 provides ~1,400 cancer genes with the depth of coverage typical of targeted panels, while achieving the genomic breadth to detect somatic copy number alterations (SCNAs), common cancer-related rearrangements, oncogenic viruses and B-cell receptor (BCR) clonotypes. Evaluated with a cancer patient cohort of 244 matched tumor/normal pairs and compared with clinically-validated results, EXaCT-2 achieved a mean sequencing depth of ~400× for critical cancer genes and ~100× for the remainder of the exome, with SCNA characterization showing improved boundary detection and overall segmentation. The assay demonstrated enhanced sensitivity for detecting sub-clonal, low-allele-frequency mutations missed by standard exome assays, such as mutations in GC-rich genes like KRAS. Analysis is performed by a modular, bespoke pipeline that leverages a workflow manager (Nextflow), in combination with containerized open-source tools. In addition to mutations and SCNAs, the pipeline reports common cancer rearrangements, hematologic oncogenic viruses, BCR clonotypes, and global molecular metrics, such as tumor mutational burden (TMB) and microsatellite instability (MSI). Collectively, these results establish EXaCT-2 as a comprehensive platform for integrated cancer genome profiling.

Journal / Series
NPJ precision oncology
Date Issued
2026-04-21
Publisher
Nature Research
Keywords
WCM Library Coordinated Deposit
Related DOI
https://doi.org/10.1038/s41698-026-01390-5
Previously Published as
Waltman P, Chandra P, Eng KW, Wilkes DC, Park H, Pabon C, Delpe P, Bhinder B, Manohar J, Kane T, Fernandez E, Gorski K, Greco N, Simi M, Tang JM, Zisimopoulos P, King A, Al Assaad M, Ten Eyck T, Roberts D, Monge J, Demichelis F, Tam W, Ouseph MM, Sigaras A, Beltran H, Rennert H, Lindeman N, Song W, Solomon J, Mosquera JM, Kim R, Catalano J, Hassane DC, Sigouros M, Elemento O, Alonso A, Sboner A. EXaCT-2: an augmented and customizable oncology-focused whole exome sequencing platform. NPJ precision oncology. 2026. doi: 10.1038/s41698-026-01390-5. PMID: 42014463.
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
Rights URI
https://creativecommons.org/licenses/by-nc-nd/4.0/
Type
article

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