A comparison of ARMS and DNA sequencing for mutation analysis in clinical biopsy samples

Background: We have compared mutation analysis by DNA sequencing and Amplification Refractory Mutation System T (ARMS T) for their ability to detect mutations in clinical biopsy specimens. Methods: We have evaluated five real-time ARMS assays: BRAF 1799T > A, [this includes V600E and V600K] and NRAS 182A > G [Q61R] and 181C > A [Q61K] in melanoma, EGFR 2573T > G [L858R], 2235-2249del15 [E746-A750del] in non-small-cell lung cancer, and compared the results to DNA sequencing of the mutation 'hot-spots' in these genes in formalin-fixed paraffin-embedded tumour (FF-PET) DNA. Results: The ARMS assays maximised the number of samples that could be analysed when both the quality and quantity of DNA was low, and improved both the sensitivity and speed of analysis compared with sequencing. ARMS was more robust with fewer reaction failures compared with sequencing and was more sensitive as it was able to detect functional mutations that were not detected by DNA sequencing. DNA sequencing was able to detect a small number of lower frequency recurrent mutations across the exons screened that were not interrogated using the specific ARMS assays in these studies. Conclusions: ARMS was more sensitive and robust at detecting defined somatic mutations than DNA sequencing on clinical samples where the predominant sample type was FF-PET.