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

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 33)
Exomes 𝑓: 0.0000014 ( 0 hom. )

Consequence

EGFR
NM_005228.5 missense

Scores

13
5
1

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:3

Conservation

PhyloP100: 9.90
Variant links:
Genes affected
EGFR (HGNC:3236): (epidermal growth factor receptor) The protein encoded by this gene is a transmembrane glycoprotein that is a member of the protein kinase superfamily. This protein is a receptor for members of the epidermal growth factor family. EGFR is a cell surface protein that binds to epidermal growth factor, thus inducing receptor dimerization and tyrosine autophosphorylation leading to cell proliferation. Mutations in this gene are associated with lung cancer. EGFR is a component of the cytokine storm which contributes to a severe form of Coronavirus Disease 2019 (COVID-19) resulting from infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). [provided by RefSeq, Jul 2020]

Genome browser will be placed here

ACMG classification

Classification made for transcript

Verdict is Likely_pathogenic. Variant got 6 ACMG points.

PM2
Very rare variant in population databases, with high coverage;
PP3
MetaRNN computational evidence supports a deleterious effect, 0.99

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
EGFRNM_005228.5 linkc.2170G>A p.Gly724Ser missense_variant Exon 18 of 28 ENST00000275493.7 NP_005219.2 P00533-1Q504U8F2YGG7

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
EGFRENST00000275493.7 linkc.2170G>A p.Gly724Ser missense_variant Exon 18 of 28 1 NM_005228.5 ENSP00000275493.2 P00533-1
EGFRENST00000455089.5 linkc.2035G>A p.Gly679Ser missense_variant Exon 17 of 26 1 ENSP00000415559.1 Q504U8
EGFRENST00000450046.2 linkc.2011G>A p.Gly671Ser missense_variant Exon 18 of 28 4 ENSP00000413354.2 C9JYS6
EGFRENST00000700145.1 linkc.517G>A p.Gly173Ser missense_variant Exon 5 of 9 ENSP00000514824.1 A0A8V8TPW8

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152222
Hom.:
0
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.0000241
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD4 exome
AF:
0.00000137
AC:
2
AN:
1461852
Hom.:
0
Cov.:
32
AF XY:
0.00000138
AC XY:
1
AN XY:
727218
show subpopulations
Gnomad4 AFR exome
AF:
0.0000299
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.00
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
8.99e-7
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152222
Hom.:
0
Cov.:
33
AF XY:
0.0000134
AC XY:
1
AN XY:
74356
show subpopulations
Gnomad4 AFR
AF:
0.0000241
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.00
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.00000378

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:3
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Uncertain:1
Mar 25, 2019
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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
Jun 25, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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
Mar 06, 2025
Ambry Genetics
Significance: Uncertain significance
Review Status: criteria provided, single submitter
Collection Method: clinical testing

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: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Pathogenic
1.0
BayesDel_addAF
Pathogenic
0.38
D
BayesDel_noAF
Pathogenic
0.31
CADD
Pathogenic
28
DANN
Uncertain
1.0
DEOGEN2
Uncertain
0.73
D;D;D
Eigen
Pathogenic
0.79
Eigen_PC
Pathogenic
0.70
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Pathogenic
0.98
D;D;D
M_CAP
Uncertain
0.28
D
MetaRNN
Pathogenic
0.99
D;D;D
MetaSVM
Uncertain
0.48
D
MutationAssessor
Uncertain
2.2
.;.;M
PrimateAI
Pathogenic
0.89
D
PROVEAN
Pathogenic
-5.2
D;.;D
REVEL
Pathogenic
0.74
Sift
Pathogenic
0.0
D;.;D
Sift4G
Pathogenic
0.0
D;D;D
Polyphen
1.0
D;.;D
Vest4
0.91
MutPred
0.95
.;.;Gain of MoRF binding (P = 0.0868);
MVP
0.94
MPC
1.4
ClinPred
1.0
D
GERP RS
5.5
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.7
Varity_R
0.93
gMVP
0.84

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.010
Details are displayed if max score is > 0.2

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

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs1051753269; hg19: chr7-55241722; COSMIC: COSV51788393; COSMIC: COSV51788393; API