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For Research Use Only.
Not for use in diagnostic procedures
Many are called…
but FEW
are CHOSEN
For Research Use Only.
Not for use in diagnostic procedures
SureSelect
Focused Exome
A Highly Targeted Design
for Deep Coverage
Background:
There are about 7,200 known rare disorders and only 4,000
have known underlying genetic cause
Disease-associated variants are identified in only 50% of
samples analyzed* = extended diagnostic odyssey
WHAT DOES “RARE” MEAN?
• “Rare” diseases affect 8% of the population
For Research Use Only.
Not for use in diagnostic procedures
8% of 7 billion people = 560 million
*Zemojtel T. Sci. Transl. Med., 2013
Out of 3 billion base pairs organized into ~20,000 genes– how do you look for the one variant linked to disease?
November 13, 2014
Confidentiality Label
4
TRIVIA:
Odds of winning the
Powerball Lottery???
1 in 175 million!!!
• Biochemical assays
• PKU:
- AR; phenylalanine hydroxylase deficiency leading to
accumulation of phenylalanine
- Untreated, may lead to profound mental retardation
PITFALLS
1. Requires a priori knowledge of specific disorder
• Symptoms would support results
2. Laborious and could get expensive if multiple
rounds are done when inconclusive
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
• Karyotyping
• Technique used to look for large-scale chromosomal
abnormalities (eg. trisomies)
PITFALLS
1. Lack of resolution (limit 4-5Mb)
• Cannot identify causal single-nucleotide variants or
microdeletions
2. Highly dependent on level of experience of
cytogeneticist or technologist
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
• aCGH
• Used to look for chromosomal abberrations such as
copy number changes
PITFALLS
1. Inability to detect other chromosomal
abberrations without copy number changes
• Balanced translocations
• Inversions
• Mosaicism
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
• Positional Candidate Gene Discovery
• Linkage mapping combined with Sanger sequencing
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
4) Study gene product function
A) Normal biology
B) Disease pathogenesis
3) Screen candidate genes in the locus
Mutation Detection
1) Identify large and/or many families with the disease
agcttgaa…(GATC)n…..aggccta
telomeric
centromeric
2) Identify disease gene locus
agcttgaa…(GATC/GATC/GATC)…..aggccta
agcttgaa…(GATC )…..aggccta
agcttgaa…(GATC /GATC)…..aggccta
• Positional Candidate Gene Discovery
• Linkage mapping combined with Sanger sequencing
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
PITFALLS
1. Requires a high number of informative meiosis
2. Locus heterogeneity leads to decreased LOD
score
3. Laborious and could get expensive if
sequencing many candidate genes
4. May result in work that takes several months to
years to complete
• Positional Candidate Gene Discovery
• Linkage mapping combined with Sanger sequencing
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
2005 2006
• Candidate gene
(Sanger) sequencing
started
• Samples collected
from 9 families
• ~5Mb disease
locus identified on
chromosome 5
2009
• STILL sequencing…
EXAMPLE:
Disease Gene Discovery for Infantile Myofibromatosis
- Rare AD proliferative disorder; benign tumor formation on skin, muscle
viscera and bone
???
• Positional Candidate Gene Discovery
• Linkage mapping combined with Sanger sequencing
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
EXAMPLE:
Disease Gene Discovery for Infantile Myofibromatosis
CHALLENGES:
• Phenotype with reduced penetrance
• Possible locus heterogeneity
NEED:
• Unbiased way to interrogate genomic regions
NGS enables increased identification of disease-causing genes
13
Boycott M. et al. Nat. Rev. Genet. 2013
Gnirke A et al. Nat. Biotech. 2009
SureSelect was introduced
For Research Use Only.
Not for use in diagnostic procedures
FACT:
>50 Mendelian disease genes
identified with SureSelect
• Positional Candidate Gene Discovery
• Linkage mapping combined with Sanger sequencing
Is there a better way of finding the needle in the haystack?
Traditional Approach
For Research Use Only.
Not for use in diagnostic procedures
2005 2006
• Candidate gene
(Sanger) sequencing
started
• Samples collected
from 9 families
• ~5Mb disease
locus identified on
chromosome 5
2009
• STILL sequencing…
EXAMPLE:
Disease Gene Discovery for Infantile Myofibromatosis
2012
• exome sequencing with SureSelect
• 2 disease genes identified:
1. PDGFRB (chr 5): 2 missense
variants present in 8 families
2. NOTCH3 (chr 19): missense
mutation in 9th family Martignetti et al. AJHG Jun 2013
15
But what about benchtop sequencer-compatible solutions?
For Research Use Only.
Not for use in diagnostic procedures
Benchtop sequencers cannot provide sufficient exome coverage due to limited output
16
For Research Use Only.
Not for use in diagnostic procedures
17
More and more sequence their own samples using benchtop sequencers in their labs
For Research Use Only.
Not for use in diagnostic procedures
18
Targeted solution for
constitutional disease
research
Compatibility with
benchtop sequencing
Highly targeted design + Efficient Workflows
= Reduced turn around time, high performing enrichment,
faster sample to data
For Research Use Only.
Not for use in diagnostic procedures
SureSelect
Focused Exome When time to answers matters
For Research Use Only.
Not for use in diagnostic procedures
20
For Research Use Only.
Not for use in diagnostic procedures
1. Focused Coverage
~20,000 genes
~5,700 genes
• 16Mb total capture size
• OMIM, HGMD and ClinVar
Deep coverage of disease-
associated targets with
minimal sequencing for
faster data analysis
Capture size compatible with
benchtop sequencers for
faster sequencing
Key Benefits: Highly targeted design for faster time to answers
21
For Research Use Only.
Not for use in diagnostic procedures
1. Focused Coverage
~20,000 genes
~5,700 genes
• 16Mb total capture size
• OMIM, HGMD and ClinVar
Cost-effective parallel
interrogation of thousands of
genes: lower cost compared
to running multiple panels
when result is inconclusive
Study of rare disorders:
comprehensive analysis of
disease-associated regions
Key Benefits: Highly targeted design for faster time to answers
IDEAL FOR:
22
For Research Use Only.
Not for use in diagnostic procedures
2. Sample to Sequencing in a Day
with SureSelectQXT
- 1.5 hr lib prep + 90 min hyb
- Single day sample to sequencing
- 30% less hands-on time
- only 50ng input
Faster sample to sequencing
Key Benefits: Highly targeted design for faster time to answers
23
For Research Use Only.
Not for use in diagnostic procedures
3. Complete and flexible solutions
from sample to data
- SureCall data analysis support from raw
variants to categorized mutations
- Customization support through SureDesign
- Library prep, sample QC, automation support
Faster sample to
variants report
Key Benefits: Highly targeted design for faster time to answers
SureSelectXT Focused Exome Deep coverage of disease-associated targets: 98% at 20x with 3Gb
2x100bp
3Gb
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
NA10831 NA18507 NA12155 NA12156 NA18997 NA12891 NA18953 NA12878
1X
10X
20X
On-target +/- 100bp: 76.5%
Dup rate: 6.4%
For Research Use Only.
Not for use in diagnostic procedures
SureSelectQXT Performance: Excellent performance, 99% at 20x, 3.5x FASTER
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
NA10831 NA18507 NA12155 NA12156 NA18997 NA12891 NA18953 NA12878
1X
10X
20X
On-target +/-100bp: 82.4%
Dup rate: 12%
For Research Use Only.
Not for use in diagnostic procedures
2x100bp
3Gb
Highly sensitive and accurate variant calling
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
XT
QXT
CONCORDANCE >98%
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
SENSITIVITY >99%
For Research Use Only.
Not for use in diagnostic procedures
2x100bp
Agilent
Confidential
Normalized to 3Gb
90%
91%
92%
93%
94%
95%
96%
97%
98%
99%
100%
1X 10X 20X
2x76
2x100
MiSeq Read Length Compatibility Comparable results between 2x100bp and 2x76bp
2x76bp
For Research Use Only.
Not for use in diagnostic procedures
SureSelectQXT Focused Exome More relevant targets captured, more comprehensive analysis
*analysis based on total capture design
Accounts only for bases within the target
overlap with padded bait BED
For Research Use Only.
Not for use in diagnostic procedures
SureSelect
Focused Exome Competitor I
Target Size 12Mb 12Mb
DATABASES COVERED
HGMD_cds 76.80% 73.63%
OMIM_cds 45.45% 41.01%
ClinVar 83.45% 81.54%
Customization Yes No
1 day workflow Yes No
SureSelectXT Focused Exome Deeper target coverage at equivalent sequencing, better variant calling
* Based on publicly-available design files
** analysis based on regions that overlap between the designs
For Research Use Only.
Not for use in diagnostic procedures
SureSelect
Focused Exome Competitor I
Design Size 16Mb 12Mb*
Recommendation 3Gb
2x100bp
2.5Gb
2x150bp
% targeted bases at 1x 99.87% 97.59%
% targeted bases at 20x 98.90% 91.37%
% targeted bases at 30x 97.60% 85.51%
% targeted bases at 50x 89.64% 68.42%
30
Our Approach….
For Research Use Only.
Not for use in diagnostic procedures
• Compatibility with low sample input
• Streamlined and scalable workflow
• Fast turn-around time
WORKFLOW + DESIGN
• Performance-optimized
designs with relevant targets
• Sensitivity and Accuracy
COMPLETE AND ACCURATE VARIANT PROFILING
faster sample to data
and
31
DESIGN WORKFLOW +
=
COMPLETE AND ACCURATE VARIANT PROFILING
Our Approach….
For Research Use Only.
Not for use in diagnostic procedures
32
• Targeted solution for constitutional disease research
• Compatibility with both high-throughput and benchtop sequencing
SureSelect Clinical Research Exome SureSelect Focused Exome
AND
For Research Use Only.
Not for use in diagnostic procedures
33
DESIGN WORKFLOW +
=
COMPLETE AND ACCURATE VARIANT PROFILING
Our Approach….
For Research Use Only.
Not for use in diagnostic procedures
COMPLETE and FLEXIBLE Solution
Superior PERFORMANCE
FASTEST Workflow
• 90 minute hybridization, fastest in the market
• Enables single day sample to sequencing
• 3.5x faster than closest competitor
• Excellent on-target and target coverage
• Highly sensitive and accurate variant calling
• Support for exomes or custom captures
• Supported by SureDesign, SureCall and NGS
library prep QC solutions
For Research Use Only.
Not for use in diagnostic procedures
SureSelectQXT
35
SureSelect: The ONLY complete solution
Enabling constitutional disease research,
accelerating discoveries
For Research Use Only.
Not for use in diagnostic procedures
SureSelect Competitor I Competitor L Competitor N
Designs optimized for deep coverage of
ONLY regions that matter
= COST-EFFECTIVE ANALYSIS
Compatibility with both high output and
benchtop sequencers Single day sample to sequencing workflow
Clinical Research Exome (for high output)
OR
Focused Exome (for benchtop)
SureSelectQXT +
FOLLOW-UP CLINICAL
RESEARCH
SureSelect: Enabling discovery, advancing clinical research
Compatibility with low sample input
Performance-optimized designs with relevant targets
Streamlined and scalable workflow
Fast turn-around time
Sensitivity and Accuracy
DISCOVERY
Reduced time from sample to data
For Research Use Only.
Not for use in diagnostic procedures
For Research Use Only.
Not for use in diagnostic procedures