To eliminate this potential ambiguity, we performed more tests to assess and compare the sensitivity thresholds of the tested methods. We used three ATCC cell lines whose KRAS mutation statuses are known and recorded in the COSMIC database: A549 (p.Gly12Ser), NCI-H620 (p.Gly12Val), and NCI-H2009 (p.Gly12Ala). We extracted sample DNA from the cell lines, measured its concentration by spectrophotometry, and then made dilution series of the DNA from the KRAS mutant cell lines in DNA from the NCI-H1975 KRAS wild-type cell line such that the mutant DNA comprised 25%, 20%, 15%, 10%, 5%, 1%, 0.5%, 0.25%, or 0.125% of the total KRAS DNA (Figure 6). Figure 6 Comparative sensitivity analysis of KRAS

typing kits in dilution series, where DNA from 7-Cl-O-Nec1 mw three mutated cell lines was diluted in wild-type DNA. Results of dilution series consisted of 25%, 20%, 15%, 10%, 5%, 1%, 0.5%, 0.25%, this website and 0.125% of mutated DNA in wild-type DNA. For threshold found in the first dilution experiment and one adjacent concentration from each side, typing was performed three times. Resulting consensus

thresholds (found two or three times out of three repeats) for cell lines A549 (p.Gly12Ser), NCI-H620 (p.Gly12Val), and NCI-H209 (p.Gly12Ala) are shown in the graph. At a mutant minority of 1%, only TheraScreen and StripAssay were capable of detecting mutations in KRAS, while other methods have detection limit at 10% (Pyrosequencing), and 25% (HRM and Sanger sequencing). Interestingly, in one technical replicate the mutation detected by the TheraScreen DxS kit in cell line A549 (p.Gly12Cys) Quinapyramine was inconsistent with what was actually present. At a mutant minority of 0.5%, the TheraScreen DxS kit only detected mutation in the NCI-H620 cell line (p.Gly12Val); the K-ras StripAssay failed to yield any positive results when analyzed using the StripAssay Evaluator software, but was judged to have correctly detected a mutation in the NCI-H620 line

on the basis of visual inspection. At a mutant minority of 0.25%, only the K-ras StripAssay yielded a positive result. Remarkably, the K-ras StripAssay was able to detect the mutation in the NCI-H2009 line (p.Gly12Ala) even at a mutant minority of 0.125%. Discussion We have examined the ability of five different methods to detect mutations in the KRAS gene in 131 DNA samples. KRAS mutations were detected in 21 LY2606368 clinical trial samples (16.0%), 107 samples were found to contain wild-type DNA (81.7%), and three yielded inconclusive results (2.2%) (Table 1). Of the 21 samples in which mutation was detected by one or more methods, there were only four for which all five yielded a positive result (19.0%). Of the 95 wild-type samples analyzed by all five methods, concordance was observed in 87 (91.6%); overall, the five methods were in agreement with one-another for 78% of the samples examined.