rs1051753269
Variant summary
Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM2PP3_Strong
The NM_005228.5(EGFR):c.2170G>A(p.Gly724Ser) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000186 in 1,614,074 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★).
Frequency
Consequence
NM_005228.5 missense
Scores
Clinical Significance
Conservation
Genome browser will be placed here
ACMG classification
Verdict is Likely_pathogenic. Variant got 6 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|---|
EGFR | ENST00000275493.7 | c.2170G>A | p.Gly724Ser | missense_variant | Exon 18 of 28 | 1 | NM_005228.5 | ENSP00000275493.2 | ||
EGFR | ENST00000455089.5 | c.2035G>A | p.Gly679Ser | missense_variant | Exon 17 of 26 | 1 | ENSP00000415559.1 | |||
EGFR | ENST00000450046.2 | c.2011G>A | p.Gly671Ser | missense_variant | Exon 18 of 28 | 4 | ENSP00000413354.2 | |||
EGFR | ENST00000700145.1 | c.517G>A | p.Gly173Ser | missense_variant | Exon 5 of 9 | ENSP00000514824.1 |
Frequencies
GnomAD3 genomes AF: 0.00000657 AC: 1AN: 152222Hom.: 0 Cov.: 33
GnomAD4 exome AF: 0.00000137 AC: 2AN: 1461852Hom.: 0 Cov.: 32 AF XY: 0.00000138 AC XY: 1AN XY: 727218
GnomAD4 genome AF: 0.00000657 AC: 1AN: 152222Hom.: 0 Cov.: 33 AF XY: 0.0000134 AC XY: 1AN XY: 74356
ClinVar
Submissions by phenotype
not specified Uncertain:1
The p.Gly724Ser variant has not been reported as a germline variant to our knowledge. However, this variant has been identified in 13 lung adenocarcinomas or non-small cell lung cancers (Brown 2019, Chung 2009, Fassunke 2018, Ogino 2005, Oztan 2017, Peled 2017, Tam 2006, Zhang 2019). In 11 of these cases, the p.Gly724Ser variant was only identified after progressive disease and in the setting of osimertinib and/or erlotinib resistance, often in the context of primary EGFR exon 19 deletions and acquired p.Thr790Met resistant mutation. Molecular modeling suggests that the p.Gly724Ser variant reduces osimertinib binding affinity in context of exon 19 deletion (Brown 2019), and in vitro functional evidence also supported that the p.Gly724Ser variant is resistant to osimertinib but may be responsive to afatinib (Brown 2019, Cho 2014, Fassunke 2018). This was also observed in one patient, where afatinib reduced the p.Gly724Ser clone identified in a metastatic liver lesion (Peled 2017). This variant has also been reported in two cases of colorectal cancer, one of which that did not respond to gefitinib (Cho 2014, Ogino 2005). In summary, while the clinical significance of this variant is uncertain in the context of a germline variant, there is evidence to support that the variant is likely resistant to osimertinib, a third-generation EGFR inhibitor in the setting of EGFR exon 19 deletions with or without in the acquired p.Thr790Met resistant mutation. -
EGFR-related lung cancer Uncertain:1
This sequence change replaces glycine, which is neutral and non-polar, with serine, which is neutral and polar, at codon 724 of the EGFR protein (p.Gly724Ser). This variant is present in population databases (no rsID available, gnomAD 0.01%). This missense change has been observed in individual(s) with lung cancer (PMID: 30610926). ClinVar contains an entry for this variant (Variation ID: 376360). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt EGFR protein function with a positive predictive value of 80%. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Hereditary cancer-predisposing syndrome Uncertain:1
The p.G724S variant (also known as c.2170G>A), located in coding exon 18 of the EGFR gene, results from a G to A substitution at nucleotide position 2170. The glycine at codon 724 is replaced by serine, an amino acid with similar properties. This alteration was identified in an individual diagnosed with lung cancer (Lu S et al. J Thorac Oncol, 2019 Apr;14:732-736). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the available evidence, the clinical significance of this variant remains unclear. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at