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Sergi  \nReceived: 28 October 2025  \nRevised: 16 December 2025  \nAccepted: 16 December 2025  \nPublished: 22 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Surgery, Sapporo Dohto Hospital, 14-3-2 Kita 17-jo Higashi, Higashi-ku, Sapporo 065-0017, Japan; [fhata@sdhmc.jp](fhata@sdhmc.jp)  \n2 Department of Clinical Laboratory, Sapporo Dohto Hospital, 14-3-2 Kita 17-jo Higashi, Higashi-ku, Sapporo 065-0017, Japan; [k-sawamoto@sdhmc.jp](k-sawamoto@sdhmc.jp)  \n3 Department of Internal Medicine, Sapporo Dohto Hospital, 14-3-2 Kita 17-jo Higashi, Higashi-ku, Sapporo 065-0017, Japan; [s-kurokawa@sdhmc.jp](s-kurokawa@sdhmc.jp)  \n4 Sapporo Female Clinic, 3-2-5 Kita 21-jo Higashi, Higashi-ku, Sapporo 065-0021, Japan; [akiko@sapporo-fc.jp](akiko@sapporo-fc.jp)  \n[5](5 Department of Clinical Engineering)[ Department of Clinical Engineering](5 Department of Clinical Engineering), [Faculty of Health Sciences](Faculty of Health Sciences), [Hokkaido University of Science](Hokkaido University of Science), [15-4-1](15-4-1)[ ](15-4-1)Maeda 7-jo, Teine-ku, Sapporo 006-8585, Japan; [furuya-d@hus.ac.jp](furuya-d@hus.ac.jp)  \n6 Academic Center, Sapporo Dohto Hospital, 14-3-2 Kita 17-jo Higashi, Higashi-ku, Sapporo 065-0017, Japan; [nsatou@sapmed.ac.jp](nsatou@sapmed.ac.jp)  \n* Correspondence: [tomomiy@sdhmc.jp](tomomiy@sdhmc.jp); Tel.: +81-11-731-1155  \nAbstract  \nBackground/Objectives: Conventional next-generation sequencing (NGS) workflows often require more than two weeks to complete, delaying treatment decisions and limiting access to precision oncology in community settings. This report aimed to demonstrate the feasibility of performing rapid, comprehensive cell-free DNA (cfDNA)-based genomic profiling by introducing a fully automated NGS workflow in a community hospital environment. Case Presentation: A postoperative patient with pancreatic ductal adenocarcinoma and liver metastasis underwent cfDNA-based liquid biopsy using plasma collected in PAXgene® Blood ccfDNA Tubes. Gene analysis was performed using the Oncomine Precision Assay GX5 on the Ion Torrent Genexus™ System (Thermo Fisher Scientific) . Three pathogenic hotspot mutations—KRAS G12R, TP53 M246I/M246K, and GNA11—and one copy number gain in PIK3CA were identified, whereas no variants were detected in a healthy volunteer control. The total turnaround time from plasma separation to report generation was approximately 27 h, requiring only 40 min of total hands-on time. Discussion: This rapid, automated workflow enabled comprehensive cfDNA analysis within a clinically practical timeframe, overcoming key limitations of conventional multi-step NGS workflows that typically require external sample shipment and specialized personnel. The results confirm the technical feasibility of conducting high-quality molecular testing ina regional hospital setting. Conclusions: This report demonstrates that fully automated cfDNA-based NGS can achieve clinically meaningful genomic profiling within 27 h in a community hospital. This advancement addresses the time and cost barriers of traditional NGS analysis and represents a significant step toward promoting precision medicine in community healthcare.  \nKeywords: liquid biopsy; next-generation sequencing; community setting  \n1. Introduction  \nBiomarker analysis plays a central role in precision cancer treatment strategies. Nextgeneration sequencing (NGS) enables rapid, large-scale gene panel analysis, allowing the identification and detection of a wide variety of actionable biomarkers that gui","cbCaiqLcrANA28d7","https://ap.wps.com/l/cbCaiqLcrANA28d7","pdf",955274,12,"English","# Abstract\n## Background/Objectives\n## Case Presentation\n## Discussion\n## Conclusions\n# Introduction","[{\"question\":\"Why is rapid NGS important in community settings?\",\"answer\":\"Conventional NGS workflows often take more than two weeks, which delays treatment decisions and restricts access to precision oncology. The report targets a timeframe compatible with clinical decision-making in community hospitals.\"},{\"question\":\"How was the liquid biopsy performed in the case?\",\"answer\":\"Plasma was collected in PAXgene Blood ccfDNA Tubes and analyzed using the Oncomine Precision Assay GX5 on the Ion Torrent Genexus system. The study identified specific hotspot mutations and a copy number gain in PIK3CA.\"},{\"question\":\"What turnaround time and hands-on time were achieved?\",\"answer\":\"The total turnaround time from plasma separation to report generation was approximately 27 hours, with about 40 minutes of total hands-on time. This supports clinically practical molecular testing in a regional hospital environment.\"}]","Liquid Biopsy and Automated Next-Generation Sequencing - Achieving Results in 27 Hours Within a Community Setting | PDF",1790762969]