16-23635002-T-C
Variant summary
Our verdict is Likely benign. Variant got -3 ACMG points: 0P and 3B. BP4_ModerateBP6
The NM_024675.4(PALB2):āc.1544A>Gā(p.Lys515Arg) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000582 in 1,614,050 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 14/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_024675.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_benign. Variant got -3 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000920 AC: 14AN: 152158Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000915 AC: 23AN: 251486Hom.: 0 AF XY: 0.0000809 AC XY: 11AN XY: 135918
GnomAD4 exome AF: 0.0000547 AC: 80AN: 1461892Hom.: 0 Cov.: 33 AF XY: 0.0000564 AC XY: 41AN XY: 727246
GnomAD4 genome AF: 0.0000920 AC: 14AN: 152158Hom.: 0 Cov.: 32 AF XY: 0.0000538 AC XY: 4AN XY: 74328
ClinVar
Submissions by phenotype
not provided Uncertain:2Benign:2
In silico analysis supports that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 27328445, 29052111, 29338072, 26283626, 22241545, 21618343, 27616075, 25503501, 27930734, 21356067, 28873162, 27997549, 29522266, 31757951, 31159747) -
PALB2: PS3:Supporting, BP1, BP4 -
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The PALB2 c.1544A>G (p.Lys515Arg) variant has been reported in the published literature in several affected individuals with breast and/or ovarian cancer (PMIDs: 26283626 (2015), 27616075 (2016), 28873162 (2017), 29052111 (2018), 29522266 (2018), and 32658311 (2021)). It has also been found in reportedly healthy controls individuals (PMID: 21618343 (2011)). It was also reported in breast cancer cases as well as in reportedly healthy individuals in a large scale breast cancer association study (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared/genes/PALB2)).A functional study showed minimal reduction in HR activity and no effect on PARPi sensitivity compared to wild-type (PMID: 31757951 (2019)). The frequency of this variant in the general population, 0.0002 (7/35438 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded predictions that this variant is benign. Based on the available information, we are unable to determine the clinical significance of this variant. -
Hereditary cancer-predisposing syndrome Uncertain:1Benign:3
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This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
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Familial cancer of breast Uncertain:2Benign:1
Curators: Marc Tischkowitz, Arleen D. Auerbach. Submitters to LOVD: Andreas Laner, Marc Tischkowitz. -
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not specified Uncertain:2
Classification criteria: Ingen andre kriterier kan anvendes end BP1. -
Variant summary: PALB2 c.1544A>G (p.Lys515Arg) results in a conservative amino acid change located in the DNA-binding domain (DBD, Nepomuceno_2020) of the encoded protein sequence. Five of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 9.3e-05 in 257362 control chromosomes, predominantly at a frequency of 0.0002 within the Latino subpopulation in the gnomAD database. The observed variant frequency within Latino control individuals in the gnomAD database exceeds the estimated maximal expected allele frequency for a pathogenic variant in PALB2 causing Hereditary Breast and Ovarian Cancer phenotype (0.00016), suggesting the variant may be a benign polymorphism found in the Latino subpopulation. c.1544A>G has been reported in the literature in individuals affected with cancer including Hereditary Breast and Ovarian Cancer and stomach adenocarcinoma but it was also reported in one healthy woman older than 50 years (Hauke_2018, He_2016, Hellebrand_2011, Kraus_2016, Lu_2015, Mandelker_2017, Maxwell_2014, Myszka_2017, Thompson_2015, Tischkowitz_2012, Tsaousis_2019, Akcay_2020). These reports do not provide unequivocal conclusions about association of the variant with Hereditary Breast And Ovarian Cancer Syndrome. Moreover, the variant was reported in the FLOSSIES database in two women older than age 70 years who have never had cancer, providing supporting evidence for a benign role. One co-occurrence with a pathogenic variant has been reported internally (APC c.4873delC, p.Gln1625fs*25; internal LCA database). At least one functional study reports this variant has slightly reducing HR activity and no effect on PARPi sensitivity compared to WT (Boonen_2019). Twelve ClinVar submitters (evaluation after 2014) cite the variant as uncertain significance (n=9) and as likely benign (n=5). Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -
PALB2-related disorder Uncertain:1
The PALB2 c.1544A>G variant is predicted to result in the amino acid substitution p.Lys515Arg. This variant has been previously reported in individuals with familial breast cancer (Thompson et al 2015. PubMed ID: 26283626; Kraus et al 2017. PubMed ID: 27616075). This variant is reported in 0.020% of alleles in individuals of Latino descent in gnomAD and in ClinVar it is classified as likely benign and a variant of uncertain significance (https://www.ncbi.nlm.nih.gov/clinvar/variation/126607/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -
Breast and/or ovarian cancer Uncertain:1
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Familial ovarian cancer Uncertain:1
The PALB2 p.Lys515Arg variant was identified in 6 of 10468 proband chromosomes (frequency: 0.00057) from individuals or families with breast or ovarian cancer and was not identified in 4896 control chromosomes from healthy individuals (Hellebrand 2011, Kraus 2017, Maxwell 2015, Myszka 2017, Thompson 2015, Tischkowitz 2012). The variant was also identified in dbSNP (ID: rs515726072) as "With Uncertain significance allele", ClinVar (classified as likely benign by Ambry Genetics; as uncertain significance by Invitae, Genedx, PALB2 database and three clinical laboratories), MutDB , and in LOVD 3.0 (1x), databases. The variant was not identified in Cosmic, or Zhejiang University Database. The variant was identified in control databases in 23 of 277248 chromosomes at a frequency of 0.00008 (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: Other in 1 of 6468 chromosomes (freq: 0.00016), Latino in 7 of 34418 chromosomes (freq: 0.0002), European in 15 of 126730 chromosomes (freq: 0.00012), while the variant was not observed in the African, Ashkenazi Jewish, East Asian, Finnish, and South Asian populations. The p.Lys515 residue is conserved in mammals but not in more distantly related organisms however computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; this information is not predictive enough to rule out pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) do not predict a difference in splicing. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time. This variant is classified as a variant of uncertain significance. -
Hereditary cancer Benign:1
This variant is considered likely benign or benign based on one or more of the following: it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease, and/or has normal protein function, and/or has lack of segregation with disease, and/or has been detected in co-occurrence with known pathogenic variant, and/or has lack of disease association in case-control studies, and/or is located in a region inconsistent with a known cause of pathogenicity. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at