rs587779834
Variant summary
Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PM5_SupportingPVS1PM3
This summary comes from the ClinGen Evidence Repository: The c.3802del (p.Val1268*) variant in ATM is a nonsense variant in a biologically-relevant-exon predicted to cause a premature stop codon leading to nonsense mediated decay in a gene in which loss-of-function is an established disease mechanism. This alteration results in a termination codon upstream of the most C-terminus pathogenic alteration (ATM p.Arg3047*), as classified by the HBOP VCEP, and is expected to be more deleterious. This variant was observed in several individuals with Ataxia-Telangiectasia (PMID:9463314, 12815592, 26896183). The highest population minor allele frequency in gnomAD v2.1.1 is 0.00008473 in the Admixed American population (PM2_Supporting, BS1, and BA1 are not met). In summary, this variant meets criteria to be classified as pathogenic for autosomal dominant ATM-related cancer predisposition and autosomal recessive Ataxia-Telangiectasia based on the ACMG/AMP criteria applied as specified by the HBOP Variant Curation Expert Panel. (PVS1, PM5_Supporting, PM3_Very Strong) LINK:https://erepo.genome.network/evrepo/ui/classification/CA286815/MONDO:0700270/020
Frequency
Consequence
NM_000051.4 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 11 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
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ATM | NM_000051.4 | c.3802delG | p.Val1268fs | frameshift_variant | Exon 26 of 63 | ENST00000675843.1 | NP_000042.3 |
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000394 AC: 6AN: 152198Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.0000398 AC: 10AN: 251154Hom.: 0 AF XY: 0.0000442 AC XY: 6AN XY: 135758
GnomAD4 exome AF: 0.0000883 AC: 129AN: 1460936Hom.: 0 Cov.: 30 AF XY: 0.0000894 AC XY: 65AN XY: 726822
GnomAD4 genome AF: 0.0000394 AC: 6AN: 152198Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74346
ClinVar
Submissions by phenotype
not provided Pathogenic:10
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; Observed in the heterozygous state in individuals with ATM-related cancers (PMID: 11606401, 18384426, 19781682, 22585167, 27433846, 30306255, 29915322, 29961768); Not observed at significant frequency in large population cohorts (gnomAD); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; Also known as 3801delG; This variant is associated with the following publications: (PMID: 16832357, 25077176, 10330348, 15039971, 29478780, 17124347, 30772474, 32866655, 34637943, 32818697, 30257646, 29922827, 28888541, 34758253, 35047863, 23585524, 19781682, 12497634, 25614872, 25037873, 8755918, 22585167, 26786923, 21787400, 27664052, 10864201, 9463314, 11606401, 18384426, 27433846, 27484032, 21445571, 21965147, 28652578, 28691344, 30306255, 9887333, 12815592, 28779002, 21665257, 26182300, 29915322, 29961768, 30303537, 29625052, 26689913, 26896183, 31589614, 32853339, 33436325, 32338768, 35626031, 33758026, 34445196, 36139606, 35264596, 33804961) -
The ATM c.3802del (p.Val1268*) variant causes the premature termination of ATM protein synthesis. This variant has been reported in the published literature in individuals with breast or pancreatic cancer (PMIDs: 33280026 (2021), 22585167 (2012), 21787400 (2011), 18384426 (2008), 11606401 (2001)) or in individuals and families with Ataxia-telangiectasia (PMID: 21965147 (2011), 17124347 (2006), 9887333 (1999), 9463314 (1998)). The frequency of this variant in the general population, 0.000085 (3/35406 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is consistent with pathogenicity. Based on the available information, this variant is classified as pathogenic. -
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DNA sequence analysis of the ATM gene demonstrated a 1 base pair deletion in exon 26, c.3802del. This sequence change results in the creation of a premature stop codon at amino acid position 1268, p.Val1268*. This sequence change is predicted to result in an abnormal transcript, which may be degraded, or may lead to the production of a truncated ATM protein with potentially abnormal function. This sequence change has been reported in the gnomAD database with a frequency of 0.0085% in Latino populations (dbSNP rs781357995). The p.Val1268* change has been described in the homozygous and compound heterozygous states in patients with ataxia telangiectasia (PMID: 8755918, 21965147). This pathogenic sequence change has previously been described in the heterozygous state in patients with breast, colon, pancreatic and prostate cancer (PMID: 29478780, 28779002, 21787400, 27433846, 22585167, 29961768). -
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ATM: PVS1, PS4:Moderate, PM2:Supporting -
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Ataxia-telangiectasia syndrome Pathogenic:9
Variant summary: ATM c.3802delG (p.Val1268X) 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. Truncations downstream of this position have been classified as pathogenic by our laboratory (e.g., p.Arg1466X and p.Ser1905fsX25). The variant allele was found at a frequency of 4e-05 in 276948 control chromosomes (gnomAD). This frequency is not higher than expected for a pathogenic variant in ATM causing Ataxia-Telangiectasia (4e-05 vs 0.004), allowing no conclusion about variant significance. c.3802delG has been reported in the literature in multiple individuals affected with Ataxia-Telangiectasia as both a homozygous and compound heterozygous allele, indicating the variant is very likely to be associated with disease. At least one publication reports functional data indicating the variant significantly impairs protein expression and kinase activity in patient cells (Carranza_2017). Five clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 and all classified the variant as pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
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This sequence change creates a premature translational stop signal (p.Val1268*) in the ATM gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in ATM are known to be pathogenic (PMID: 23807571, 25614872). This variant is present in population databases (rs765158119, gnomAD 0.009%). This premature translational stop signal has been observed in individual(s) with ataxia-telangiectasia (A-T), and breast cancer (PMID: 8755918, 9887333, 10330348, 10864201, 11606401, 12815592, 16832357, 18384426, 21787400, 23585524, 25077176, 25614872). It is commonly reported in individuals of British Isles ancestry (PMID: 8755918, 9463314, 9887333, 10330348, 10864201, 11606401, 12815592, 16832357, 18384426, 21787400, 22585167, 23585524, 25077176, 25614872). This variant is also known as c.3801delG. ClinVar contains an entry for this variant (Variation ID: 127374). For these reasons, this variant has been classified as Pathogenic. -
Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Pathogenic. Following criteria are met: 0102 - Loss of function is a known mechanism of disease in this gene and is associated with ataxia-telangiectasia (MIM#208900). (I) 0106 - This gene is associated with autosomal recessive disease. Carriers of ATM pathogenic variants are at increased risk of developing cancer (mainly breast cancer) (GeneReviews). (I) 0115 - Variants in this gene are known to have variable expressivity. Variable age of onset and rate of disease progression have been reported for affected individuals within the same family (PMIDs: 20301790, 27884168). (I) 0201 - Variant is predicted to cause nonsense-mediated decay (NMD) and loss of protein (premature termination codon is located at least 54 nucleotides upstream of the final exon-exon junction). (SP) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD <0.01 for a recessive condition (v2: 11 heterozygotes, 0 homozygotes). (SP) 0701 - Other NMD predicted variants comparable to the one identified in this case have very strong previous evidence for pathogenicity (ClinVar, DECIPHER). (SP) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. It has been reported in multiple homozygotes and compound heterozygotes individuals with ataxia-telangiectasia, and families with various types of cancer (ClinVar). (SP) 1205 - This variant has been shown to be maternally inherited (by segregation analysis). (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
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Familial cancer of breast Pathogenic:6
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PVS1, PS3_MOD, PM3_VSTR -
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ACMG classification criteria: PVS1 very strong, PS3 supporting, PS4 moderated, PM2 moderated, PM3 moderated -
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This variant is considered pathogenic. This variant creates a termination codon and is predicted to result in premature protein truncation. -
Hereditary cancer-predisposing syndrome Pathogenic:3
This variant deletes 1 nucleotide in exon 26 of the ATM gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been reported in the homozygous or compound heterozygous state with an additional pathogenic ATM variant in individuals affected with ataxia-telangiectasia (PMID: 8755918, 9887333, 10864201, 21965147, 25077176, 25614872, 27664052, 34337741). This variant has also been reported in individuals affected with breast cancer (PMID: 16832357, 18384426, 21445571, 21787400), pancreatic cancer (PMID: 22585167), prostate cancer (PMID: 27433846, 33436325), and gastroesophageal junction adenocarcinoma (PMID: 35078243). This variant has been identified in 11/282542 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of ATM function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
The c.3802delG (p.V1268*) alteration, located in exon 26 (coding exon 25) of the ATM gene, consists of a deletion of one nucleotide at position 3802, causing a translational frameshift with a predicted alternate stop codon at amino acid position 1268. This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. Based on data from gnomAD, the c.3802delG allele has an overall frequency of 0.004% (11/282542) total alleles studied. The highest observed frequency was 0.009% (3/35406) of Latino alleles. This alteration has been reported in breast cancer, pancreatic cancer, prostate cancer, colorectal cancer and ataxia-telangiectasia (AT) families (McConville, 1996; Goldgar, 2011; Roberts, 2012; Podralska, 2014; Pritchard, 2016; AlDubayan, 2018; Yurgelun, 2019). Based on the available evidence, this alteration is classified as pathogenic. -
The c.3802del (p.Val1268*) variant generates a stop codon that is predicted to result in a truncated or absent protein, due to nonsense mediated decay (NMD) (PVS1). It has an allele frequency of 0.0034%, (9/268,016 alleles) in the gnomAD v2.1.1 non-cancer dataset, with a maximal frequency of 0.0086%, (3/35,074 alleles) in the the Latino / Admixed American subpopulation (no population frequency criterion met; http://gnomad.broadinstitute.org). It has been reported in at least eighteen ataxia-telangiectasia probands in homozygosis or together with (likely) pathogenic variants, which awards 4 points to this variant as per ClinGen SVI Recommendation for in trans Criterion (PM3_VeryStrong; PMID: 27664052, 10330348, 12815592, 21665257, 21965147, 8755918, 9887333). Moreover, lymphoblastoid cell lines of patients carrying this variant have been reported to have residual or absent ATM protein expression, no detectable ATM p.Ser1981 autophosphorylation, weak transphosphorylation activity of two substrates and intermediate or high radiosensitivity (PS3; PMID: 10864201, 27664052, 25077176). Therefore, this variant meets criteria to be classified as pathogenic. Adapted ACMG/AMP rules applied as defined by the Spanish ATM working group: PVS1 + PM3_VeryStrong + PS3 (PMID: 33280026). -
Ataxia-telangiectasia syndrome;C0346153:Familial cancer of breast Pathogenic:2Other:1
Variant classified as Pathogenic and reported on 01-28-2018 by Invitae. GenomeConnect-Invitae Patient Insights Network assertions are reported exactly as they appear on the patient-provided report from the testing laboratory. Registry team members make no attempt to reinterpret the clinical significance of the variant. Phenotypic details are available under supporting information. -
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ATM-related cancer predisposition syndrome Pathogenic:1
The ATM c.3802del (p.Val1268Ter) nonsense variant, also referred to as c.3801delG, is expected to result in the loss of normal protein function through either protein truncation or nonsense-mediated mRNA decay. Across a selection of the available literature, this variant has been identified in trans with a likely pathogenic or pathogenic ATM variant in multiple individuals with a diagnosis of ataxia-telangiectasia, including at least one individual whose cells showed evidence of reduced protein expression and kinase activity (PMID: 8755918; 9887333; 25614872; 27664052). In addition, truncating variants in ATM, including the p.Val1268Ter variant, have been associated with an increased risk of breast cancer (OR=3.26; 95% CI 1.82-6.46). This variant has also been reported as a germline variant in individuals with pancreatic, prostate, and other cancers (PMID: 29922827; 28779002; 33436325). This variant is reported in the Genome Aggregation Database in six alleles at a frequency of 0.000088 in the European (non-Finnish) population (version 3.1.2) and has been classified as pathogenic by at least 28 submitters in ClinVar. Based on the collective evidence, the c.3802del (p.Val1268Ter) variant is classified as pathogenic for ATM-related cancer predisposition syndrome. -
Breast and/or ovarian cancer Pathogenic:1
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ATM-related cancer predisposition Pathogenic:1
The c.3802del (p.Val1268*) variant in ATM is a nonsense variant in a biologically-relevant-exon predicted to cause a premature stop codon leading to nonsense mediated decay in a gene in which loss-of-function is an established disease mechanism. This alteration results in a termination codon upstream of the most C-terminus pathogenic alteration (ATM p.Arg3047*), as classified by the HBOP VCEP, and is expected to be more deleterious. This variant was observed in several individuals with Ataxia-Telangiectasia (PMID: 9463314, 12815592, 26896183). The highest population minor allele frequency in gnomAD v2.1.1 is 0.00008473 in the Admixed American population (PM2_Supporting, BS1, and BA1 are not met). In summary, this variant meets criteria to be classified as pathogenic for autosomal dominant ATM-related cancer predisposition and autosomal recessive Ataxia-Telangiectasia based on the ACMG/AMP criteria applied as specified by the HBOP Variant Curation Expert Panel. (PVS1, PM5_Supporting, PM3_Very Strong) -
ATM-related disorder Pathogenic:1
The ATM c.3802delG variant is predicted to result in premature protein termination (p.Val1268*). This variant has been reported in the homozygous or compound heterozygous states in several individuals with ataxia telangiectasia (McConville et al. 1996. PubMed ID: 8755918; Stankovic et al. 1998. PubMed ID: 9463314; Sandoval et al. 1999. PubMed ID: 9887333; Podralska et al. 2014. PubMed ID: 25614872), and individuals with breast and pancreatic cancer (Dörk et al. 2001. PubMed ID: 11606401; Roberts et al. 2012. PubMed ID: 22585167). This variant is reported in 0.0085% of alleles in individuals of Latino descent in gnomAD and is interpreted as pathogenic in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/127374/). Nonsense variants in ATM are expected to be pathogenic. This variant is interpreted as pathogenic. -
Familial pancreatic carcinoma Pathogenic:1
The ATM p.Val1268X variant was identified in 9 of 8368 proband chromosomes (frequency: 0.001) from Spanish, British, Australian and North American individuals or families with BRCA1/2 negative breast cancer, metastatic prostate cancer, or pancreatic cancer and was not identified in 2972 control chromosomes from healthy individuals (Brunet 2008 PMID:18384426, Goldgar 2011 PMID:21787400, Grana 2011 PMID:21445571, Pritchard 2016 PMID:27433846, Renwick 2006 PMID:16832357, Roberts 2012 PMID:22585167). The variant was also identified in dbSNP (ID: rs765158119, currently merged with rs587779834) “With Pathogenic allele”, ClinVar (classified pathogenic by GeneDx, Ambry Genetics, Invitae, Counsyl and Color Genomics Inc.), Clinvitae (3x), Cosmic (1x in lymphoid neoplasm), LOVD 3.0 (1x in lymphoid neoplasm), and was not identified in GeneInsight-COGR, MutDB, the 1000 Genomes Project, the NHLBI GO Exome Sequencing Project, the Exome Aggregation Consortium (August 8th 2016), or the Genome Aggregation Database (Feb 27, 2017). The c.3802delG variant leads to a premature stop codon at position 1268 which is predicted to lead to a truncated or absent protein and loss of function. Loss of function variants of the ATM gene are an established mechanism of disease in ATM-associated cancer and is the type of variant expected to cause the disorder. In summary, based on the above information this variant meets our laboratory’s criteria to be classified as pathogenic. -
Breast carcinoma Pathogenic:1
Invasive Ductal Carcinoma Estrogen Receptor: Positive Progesterone Receptor: Positive HER2 Receptor: Positive -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at