14-65102315-C-T

Variant names:

• chr14-65102315-C-T
• rs201743423
• NM_002382.5:c.25G>A

Variant summary

Our verdict is Uncertain significance. The variant received 2 ACMG points: 2P and 0B. PM2

The NM_002382.5(MAX):​c.25G>A​(p.Val9Met) variant causes a missense change. The variant was absent in control chromosomes in GnomAD project. Variant has been reported in ClinVar as Uncertain significance (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. V9L) has been classified as Uncertain significance.

• Frequency: Genomes: not found (cov: 32)
• Consequence: MAX NM_002382.5 missense
• Clinical Significance: Uncertain significance criteria provided, single submitter U:1
• Conservation: PhyloP100: 4.29
• Publications: 0 publications found

Genes affected

MAX (HGNC:6913): (MYC associated factor X) The protein encoded by this gene is a member of the basic helix-loop-helix leucine zipper (bHLHZ) family of transcription factors. It is able to form homodimers and heterodimers with other family members, which include Mad, Mxi1 and Myc. Myc is an oncoprotein implicated in cell proliferation, differentiation and apoptosis. The homodimers and heterodimers compete for a common DNA target site (the E box) and rearrangement among these dimer forms provides a complex system of transcriptional regulation. Mutations of this gene have been reported to be associated with hereditary pheochromocytoma. A pseudogene of this gene is located on the long arm of chromosome 7. Alternative splicing results in multiple transcript variants. [provided by RefSeq, Aug 2012]

MAX Gene-Disease associations (from GenCC):

• hereditary pheochromocytoma-paraganglioma

  Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, ClinGen
• pheochromocytoma

  Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Ambry Genetics, Labcorp Genetics (formerly Invitae)
• polydactyly-macrocephaly syndrome

  Inheritance: AD Classification: LIMITED Submitted by: Ambry Genetics

ACMG classification

Our verdict: Uncertain_significance. The variant received 2 ACMG points.

• PM2: Very rare variant in population databases, with high coverage

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
MAX	NM_002382.5	c.25G>A	p.Val9Met	missense_variant	Exon 1 of 5	ENST00000358664.9	NP_002373.3

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
MAX	ENST00000358664.9	c.25G>A	p.Val9Met	missense_variant	Exon 1 of 5	1	NM_002382.5	ENSP00000351490.4

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD4 exome Cov.: 32

GnomAD4 genome Cov.: 32

ClinVar

Significance: Uncertain significance

Submissions summary: Uncertain:1

Revision: criteria provided, single submitter

Submissions by phenotype

Hereditary cancer-predisposing syndrome Uncertain:1

May 12, 2025

Ambry Genetics

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The p.V9M variant (also known as c.25G>A), located in coding exon 1 of the MAX gene, results from a G to A substitution at nucleotide position 25. The valine at codon 9 is replaced by methionine, an amino acid with highly similar properties. This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear. -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.81
BayesDel_addAF	Pathogenic	0.22	D
BayesDel_noAF	Uncertain	0.070
CADD	Pathogenic	28
DANN	Uncertain	1.0
DEOGEN2	Benign	0.15	.;.;.;.;.;.;T;.;T;.;T;.
Eigen	Uncertain	0.53
Eigen_PC	Uncertain	0.55
FATHMM_MKL	Benign	0.51	D
LIST_S2	Uncertain	0.91	D;D;.;T;D;D;D;.;D;D;D;D
M_CAP	Pathogenic	0.96	D
MetaRNN	Uncertain	0.52	D;D;D;D;D;D;D;D;D;D;D;D
MetaSVM	Pathogenic	1.1	D
MutationAssessor	Benign	1.5	L;L;L;.;L;L;.;L;.;.;.;L
PhyloP100		4.3
PrimateAI	Pathogenic	0.88	D
PROVEAN	Benign	-2.1	N;N;.;N;N;N;N;N;N;N;N;N
REVEL	Pathogenic	0.65
Sift	Uncertain	0.0070	D;D;.;.;D;D;D;D;D;D;D;D
Sift4G	Uncertain	0.017	D;T;T;.;D;D;D;T;T;T;T;D
Polyphen		0.51, 0.95, 1.0, 0.58, 0.53	.;P;P;D;.;P;.;P;P;.;.;.
Vest4		0.57
MutPred		0.25		Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);Gain of catalytic residue at I7 (P = 0.0025);
MVP		0.83
MPC		1.1
ClinPred		0.93	D
GERP RS		4.8
PromoterAI		0.047	Neutral
Varity_R		0.81
gMVP		0.46
Mutation Taster		=23/77	disease causing

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.0		Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Other links and lift over

dbSNP: rs201743423; hg19: chr14-65569033; COSMIC: COSV52419350; COSMIC: COSV52419350;