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Journal of Pathology and Translational Medicine 2021;55(5): 324-329.
doi: https://doi.org/10.4132/jptm.2021.07.15
Robust home brew fragment sizing assay for detection of MET exon 14 skipping mutation in non–small cell lung cancer patients in resource constrained community hospitals
Anurag Mehta1 , Shrinidhi Nathany2 , Aanchal Chopra2 , Sakshi Mattoo2 , Dushyant Kumar2 , Manoj Kumar Panigrahi2
1Department of Laboratory Services, Molecular Diagnostics and Transfusion Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2Section of Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
Corresponding Author: Shrinidhi Nathany ,Tel: +91-11-47022030, Fax: +91-11-27051037, Email: drshrinidhinathany@gmail.com
Received: May 11, 2021;  Revised: June 8, 2021  Accepted: July 15, 2021.  Published online: September 2, 2021.

A mutation/deletion involving donor or acceptor sites for exon 14 results in splicing out of exon 14 of the mesenchymal epithelial transition (MET) gene and is known as “MET exon 14 skipping” (ΔMET14). The two recent approvals with substantial objective responses and improved progression-free survival to MET inhibitors namely capmatinib and tepotinib necessitate the identification of this alteration upfront. We herein describe our experience of ΔMET14 detection by an mRNA-based assay using polymerase chain reaction followed by fragment sizing.
This is a home brew assay which was developed with the concept that the transcripts from true ΔMET14 will be shorter by ~140 bases than their wild type counterparts. The cases which were called MET exon 14 skipping positive on next-generation sequencing (NGS) were subjected to this assay, along with 13 healthy controls in order to establish the validity for true negatives.
Thirteen cases of ΔMET14 mutation were detected on NGS using RNA-based sequencing. Considering NGS as a gold standard, the sizing assay using both gel and capillary electrophoresis that showed 100% specificity for both with concordance rates of 84.6% and 88.2% with NGS, respectively, were obtained.
Owing to the cost-effective nature and easy to use procedures, this assay will prove beneficial for small- and medium-sized laboratories where skilled technical personnel and NGS platforms are unavailable.
Key Words: MET exon 14 skipping; Lung neoplasms; Fragment sizing assay; Home brew; Electrophoresis
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