11-108320009-C-CTT
Variant summary
Our verdict is Pathogenic. Variant got 16 ACMG points: 16P and 0B. PVS1PP5_Very_Strong
The NM_000051.4(ATM):c.6404_6405insTT(p.Arg2136fs) variant causes a frameshift change. The variant allele was found at a frequency of 0.0000105 in 1,612,378 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★). Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000051.4 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 16 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
---|---|---|---|---|---|---|---|---|
ATM | NM_000051.4 | c.6404_6405insTT | p.Arg2136fs | frameshift_variant | Exon 44 of 63 | ENST00000675843.1 | NP_000042.3 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00000657 AC: 1AN: 152146Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.00000401 AC: 1AN: 249666Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 135144
GnomAD4 exome AF: 0.0000110 AC: 16AN: 1460232Hom.: 0 Cov.: 29 AF XY: 0.0000138 AC XY: 10AN XY: 726502
GnomAD4 genome AF: 0.00000657 AC: 1AN: 152146Hom.: 0 Cov.: 32 AF XY: 0.00 AC XY: 0AN XY: 74310
ClinVar
Submissions by phenotype
Ataxia-telangiectasia syndrome Pathogenic:5
Variant summary: ATM c.6404_6405insTT (p.Arg2136X) results in a premature termination codon, predicted to cause a truncation of the encoded protein or absence of the protein due to nonsense mediated decay, which are commonly known mechanisms for disease. The variant allele was found at a frequency of 7.3e-06 in 275474 control chromosomes (gnomAD). The variant, c.6404_6405insTT, has been reported in the literature in multiple individuals affected with Ataxia-Telangiectasia (Micol_2011, Telatar_1996) and breast cancer (Churpek_2015). These data indicate that the variant is very likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Four clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
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This sequence change creates a premature translational stop signal (p.Arg2136*) in the ATM gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in ATM are known to be pathogenic (PMID: 23807571, 25614872). This variant is present in population databases (rs587782554, gnomAD 0.004%). This premature translational stop signal has been observed in individual(s) with breast cancer and ataxia-telangiectasia (PMID: 8659541, 9463314, 21792198, 25428789). This variant is also known as 6404insTT. ClinVar contains an entry for this variant (Variation ID: 220763). RNA analysis performed to evaluate the impact of this premature translational stop signal on mRNA splicing indicates it does not significantly alter splicing (internal data). For these reasons, this variant has been classified as Pathogenic. -
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Familial cancer of breast Pathogenic:3
This variant is considered pathogenic. This variant creates a termination codon and is predicted to result in premature protein truncation. -
PVS1, PM2, PM5, PP2, PP3 -
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not provided Pathogenic:2
Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; This variant is associated with the following publications: (PMID: 27693457, 29753700, 29922827, 8659541, 25428789, 26786923, 21792198, 9463314, 28779002, 25614872, 23807571, 21665257, 26896183, 33436325, 35626031, 34507142) -
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Hereditary cancer-predisposing syndrome Pathogenic:2
This variant inserts 2 nucleotides in exon 44 of the ATM gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been identified in an individual with triple-negative breast cancer (PMID: 25428789) and an individual with early onset breast cancer (Color Health internal data). In addition, this variant has been observed in at least one individual affected with autosomal recessive ataxia-telangiectasia (PMID: 10330348). In a large international case-control study, this variant was reported in 2/60466 breast cancer cases and 1/53461 controls (PMID: 33471991). In a separate case-control study conducted in East Anglia, this variant was reported in 1/13807 breast cancer cases and absent in 5488 controls (PMID: 28779002). This variant has been identified in 2/281068 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of ATM function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
The c.6404_6405insTT pathogenic mutation, located in coding exon 43 of the ATM gene, results from an insertion of two nucleotides at position 6404, causing a translational frameshift with a predicted alternate stop codon (p.R2136*). This alteration has been reported in one individual with ataxia-telangiectasia (Telatar M et al. Am. J. Hum. Genet. 1996 Jul;59:40-4). This alteration has also been detected in multiple individuals diagnosed with breast and/or prostate cancer (Churpek JE et al. Breast Cancer Res. Treat. 2015 Jan;149:31-9; Decker B et al. J. Med. Genet. 2017 Nov;54:732-741; Karlsson Q et al. Eur Urol Oncol, 2021 Aug;4:570-579). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). In addition to the clinical data presented in the literature, this alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -
Ataxia-telangiectasia syndrome;C0346153:Familial cancer of breast Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at