rs121913344
Variant summary
Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000546.6(TP53):c.916C>T(p.Arg306*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,884 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 Pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. R306R) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000546.6 stop_gained
Scores
Clinical Significance
Conservation
Publications
- breast cancerInheritance: AD Classification: DEFINITIVE Submitted by: Ambry Genetics
- Li-Fraumeni syndromeInheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Labcorp Genetics (formerly Invitae), G2P, ClinGen, Orphanet
- Li-Fraumeni syndrome 1Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Genomics England PanelApp
- adrenocortical carcinoma, hereditaryInheritance: AD Classification: STRONG Submitted by: Ambry Genetics
- sarcomaInheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
- bone marrow failure syndrome 5Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
- colorectal cancerInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
- choroid plexus carcinomaInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
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ACMG classification
Our verdict: Pathogenic. The variant received 18 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.00 AC: 0AN: 152106Hom.: 0 Cov.: 31
GnomAD4 exome AF: 6.84e-7 AC: 1AN: 1461884Hom.: 0 Cov.: 33 AF XY: 0.00000138 AC XY: 1AN XY: 727244 show subpopulations
GnomAD4 genome Data not reliable, filtered out with message: AC0 AF: 0.00 AC: 0AN: 152106Hom.: 0 Cov.: 31 AF XY: 0.00 AC XY: 0AN XY: 74292
ClinVar
Submissions by phenotype
not provided Pathogenic:6
The TP53 c.916C>T; p.Arg306Ter variant (rs121913344) is published in the medical literature in several individuals with cancer or suspected Li-Fraumeni syndrome, and is described as segregating with disease (Hettmer 2014, Holmfeldt 2013, Klein 2017, Paixao 2018, Rajkumar 2018). The variant is reported as pathogenic or likely pathogenic in the ClinVar database (Variation ID: 142144) but is absent from general population databases (Exome Variant Server, Genome Aggregation Database), indicating it is not a common polymorphism. This variant induces an early termination codon and is predicted to result in a truncated protein or mRNA subject to nonsense-mediated decay. Considering available information, this variant is classified as pathogenic. References: Hettmer S et al. Anaplastic rhabdomyosarcoma in TP53 germline mutation carriers. Cancer. 2014 Apr 1;120(7):1068-75. Holmfeldt L et al. The genomic landscape of hypodiploid acute lymphoblastic leukemia. Nat Genet. 2013 Mar;45(3):242-52. Klein JD and Kupferman ME. Li-Fraumeni syndrome presenting as mucosal melanoma: Case report and treatment considerations. Head Neck. 2017 Feb;39(2):E20-E22. Paixao D et al. Whole-body magnetic resonance imaging of Li-Fraumeni syndrome patients: observations from a two rounds screening of Brazilian patients. Cancer Imaging. 2018 Aug 14;18(1):27. Rajkumar T et al. Targeted Resequencing of 30 Genes Improves the Detection of Deleterious Mutations in South Indian Women with Breast and/or Ovarian Cancers. Asian Pac J Cancer Prev. 2015;16(13):5211-7. -
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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; Published functional studies demonstrate reduced DNA binding activity compared to wildtype (Malcikova 2010); Not observed in large population cohorts (Lek 2016); This variant is associated with the following publications: (PMID: 21512767, 22923510, 25915410, 26796102, 25479140, 25525159, 28091804, 30107858, 20128691, 24382691, 22216294, 24371653, 16312222, 25370038, 23852799, 18757330, 22040862, 22915647, 26425688, 25773284, 10319873, 20432502, 9067756, 23334668, 23255406, 20522432, 27726232, 26667234, 28573494, 28315634, 27926791, 27626311, 26225655, 29484706, 30546467, 30720243, 31081129, 33138793, 31105275, 33294277) -
The TP53 c.916C>T (p.Arg306*) variant causes the premature termination of TP53 protein synthesis. This variant has been reported in the published literature in individuals with clinical features of Li-Fraumeni syndrome including rhabdomyosarcoma in childhood (PMID: 9067756 (1997), 24382691 (2014)), chondrosarcoma (PMID: 30107858 (2018)), and breast cancer (PMID: 26225655 (2015), 33758026 (2022)). This variant has also been reported as a somatic and germline variant in pediatric Acute Lymphoblastic Leukemia (ALL) (PMID: 23334668 (2013)). In a large-scale breast cancer association study, the variant was observed in an individual with breast cancer (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared/genes/TP53)). Published functional studies showed decreased DNA binding of TP53 protein resulting from this variant relative to the wildtype TP53 to the promoter of downstream genes (PMID: 20128691 (2010)). This variant has not been reported in large, multi-ethnic general populations (Genome Aggregation Database, http://gnomad.broadinstitute.org). Based on the available information, this variant is classified as pathogenic. -
TP53: PVS1, PM2, PS4:Moderate -
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Hereditary cancer-predisposing syndrome Pathogenic:4
This variant changes 1 nucleotide in exon 8 of the TP53 gene, creating a premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been reported in many individuals affected with Li-Fraumeni syndrome and/or breast cancer (PMID: 11370630, 22551548, 28573494, 30607672, 31081129, 31119730, 33471991, 34049842, 34240179; Color Health internal data). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Loss of TP53 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
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The p.R306* pathogenic mutation (also known as c.916C>T), located in coding exon 7 of the TP53 gene, results from a C to T substitution at nucleotide position 916. This changes the amino acid from an arginine to a stop codon within coding exon 7. This mutation was reported in a woman with a history of rhabdomyosarcoma at age 4 and breast cancer at age 22, and in a child diagnosed with anaplastic rhabdomyosarcoma at 28 months (Cornelis RS et al. Hum. Mutat. 1997;9(2):157-63; Hettmer S et al. Cancer. 2014 Apr 1;120(7):1068-75). It was also observed in three cases of pediatric ALL (Holmfeldt L et al. Nat. Genet. 2013 Mar;45(3):242-52), and in one Hispanic familial leukemia kindred (Powell BC et al. Pediatr. Blood Cancer. 2013 Jun;60(6):E1-3). In vitro studies demonstrated that p.R306* results in a p53 protein that is unable to bind the promoters of three genes (CDKN1A, MDM2, and BAX) which represent three major p53-dependent pathways responsible for cell cycle arrest, apoptosis and autoregulation (Malcikova J et al. J. Biol. Chem. 2010 Feb-Mar;391(2-3):197-205). 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. -
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Li-Fraumeni syndrome 1 Pathogenic:3
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Li-Fraumeni syndrome Pathogenic:3
This sequence change creates a premature translational stop signal (p.Arg306*) in the TP53 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in TP53 are known to be pathogenic (PMID: 20522432). This variant is not present in population databases (gnomAD no frequency). This premature translational stop signal has been observed in individual(s) with breast cancer, melanoma, leukemia, and sarcomas (PMID: 9067756, 23255406, 24382691, 27726232, 30107858). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 142144). For these reasons, this variant has been classified as Pathogenic. -
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Variant summary: TP53 c.916C>T (p.Arg306X) 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 was absent in 251484 control chromosomes (gnomAD). c.916C>T has been reported in the literature in individuals affected with Li-Fraumeni Syndrome (e.g., Penkert_2022). These data suggest the variant is very likely to be associated with disease. The following publication was ascertained in the context of this evaluation (PMID: 35974385). Multiple submitters have cited clinical-significance assessments for this variant to ClinVar after 2014. All submitters classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Lung adenocarcinoma Pathogenic:1
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Gastric cancer Pathogenic:1
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Hereditary breast ovarian cancer syndrome Pathogenic:1
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Ovarian neoplasm Pathogenic:1
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Lip and oral cavity carcinoma Pathogenic:1
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Neoplasm Other:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at