%0 Journal Article %A Truong, Truong T %A Mikloska, Klara %A Sum, Judith %A Oberländer, Martina %A von Bubnoff, Nikolas %A Christiansen, Lea %A Tornow, Sebastian %A Derer, Stefanie %A Janke, Florian %A Sültmann, Holger %A Zeissig, Sebastian %A Linnebacher, Michael %A Schafmayer, Clemens %A Lehnert, Michael %A Hutzenlaub, Tobias %A Paust, Nils %A Juelg, Peter %T Coupling Immunoprecipitation with Multiplexed Digital PCR for Cell-Free DNA Methylation Detection in Small Plasma Volumes of Early-Onset Colorectal Cancer. %J Analytical chemistry %V 97 %N 21 %@ 0003-2700 %C Columbus, Ohio %I American Chemical Society %M DKFZ-2025-01006 %P 11259-11268 %D 2025 %Z 2025 Jun 3;97(21):11259-11268 %X Colorectal cancer (CRC) remains a major global health challenge, with an increasing incidence of early-onset cases among young adults. Targeted analysis of cell-free DNA (cfDNA) methylation in blood has emerged as a promising minimally invasive diagnostic approach. While digital PCR (dPCR) offers high sensitivity and low turnaround times, conventional bisulfite-based dPCR assays require large plasma volumes due to cfDNA degradation, limiting clinical feasibility. To overcome this limitation, we developed a bisulfite-free, low-plasma-volume assay by coupling cell-free methylated DNA immunoprecipitation (cfMeDIP) with multiplexed dPCR for methylation detection. Assays were designed for CRC targets based on publicly available bisulfite-based plasma data and optimized for native, bisulfite-untreated cfDNA. The cfMeDIP-dPCR assays were first developed and optimized on circulating tumor DNA surrogates derived from HCT116 cells and subsequently validated in a pilot study, including 32 early-onset CRC (EO-CRC) patients and 29 non-CRC individuals. Methylation ratios, defined as the proportion of methylated to total cfDNA copies per marker, served as a diagnostic indicator. Three out of four selected markers (SEPT9, KCNQ5, and C9orf50) were successfully adapted, with significantly higher methylation ratios (p ≤ 0.001) in the EO-CRC cohort. KCNQ5 demonstrated the highest diagnostic performance, achieving an 85 %F PUB:(DE-HGF)16 %9 Journal Article %$ pmid:40380352 %R 10.1021/acs.analchem.5c01361 %U https://inrepo02.dkfz.de/record/301368