# Analytical and Clinical Validation of Solo‐Test Driver: A Targeted Amplicon‐Based NGS Test‐System for FFPE and cfDNA Analysis in Clinical Oncology Setting

## TL;DR

The Solo-test Driver is a reliable and cost-effective NGS test for detecting cancer-related genetic changes in clinical settings.

## Contribution

The paper introduces and validates a new NGS test system for clinical oncology with high sensitivity and specificity.

## Key findings

- The test can identify additional cancer patients with actionable mutations compared to FDA-approved PCR tests.
- It shows high intra-lab and inter-lab robustness with consistent coverage uniformity and correlation.
- Clinical validation confirms high performance for detecting SNVs, CNVs, and MSI.

## Abstract

Next‐generation sequencing (NGS) is increasingly integrated into cancer patient management, necessitating cost‐effective, reliable tests for companion diagnostics. We present the validation of the Solo‐test Driver panel, a custom NGS amplicon‐based tool for DNA analysis of 34 oncogenes, addressing key clinical needs.

The panel's performance was validated for detecting SNVs, CNVs, and MSI. Analytical validation used 182 samples, while clinical validation involved 130 samples, both encompassing diverse tumor types and specimen formats.

The Solo‐test Driver panel has the potential to identify an additional 18.3%, 16.5%, and 8.7% of RAS+ colorectal, PIK3CA+ breast, and EGFR+ lung cancer patients, respectively, when compared to FDA‐approved PCR tests. Analytical validation demonstrated high intra‐lab robustness (coefficient of variation of coverage uniformity 6.4%) and high inter‐lab robustness (PCC of per‐amplicon coverage 0.82, 0.84, 0.9 for three different labs). Estimated in silico sensitivity was 100% for detecting clinically actionable SNVs at 250x, corresponding to only 60,000 read pairs per sample. In vitro mixing experiments determined LoD starting from 3.3% VAF. Estimated in silico LoD ranged from 0.5% to 5% at 1000× (1% to 5% at 650x). Clinical validation demonstrated PPA/NPA of 100%/80%, 95%/100%, and 100%/100% for detecting MSI, SNVs, and CNVs, respectively.

The Solo‐test Driver panel offers a reliable, cost‐effective solution for detecting somatic alterations and genomic signatures, making it suitable for routine companion diagnostics in solid tumors.

With the growing demand for compact next‐generation sequencing (NGS) test systems tailored to meet key needs in oncology, the Solo‐test Driver panel serves as a valuable tool for companion diagnostics of solid tumors, demonstrating high reliability, sensitivity, and specificity in line with established guidelines. In this work, we outline the framework used to validate panels like the Solo‐test Driver panel.