rs587782527
Variant summary
Our verdict is Likely benign. The variant received -2 ACMG points: 0P and 2B. BP4BS2_Supporting
The NM_007194.4(CHEK2):c.1216C>T(p.Arg406Cys) variant causes a missense change. The variant allele was found at a frequency of 0.0000638 in 1,613,698 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R406H) has been classified as Likely benign.
Frequency
Consequence
NM_007194.4 missense
Scores
Clinical Significance
Conservation
Publications
- CHEK2-related cancer predispositionInheritance: AD Classification: DEFINITIVE Submitted by: Ambry Genetics
- hereditary breast carcinomaInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), ClinGen
- Li-Fraumeni syndrome 2Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
- acute myeloid leukemiaInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- hereditary nonpolyposis colon cancerInheritance: AD Classification: LIMITED Submitted by: ClinGen
- familial ovarian cancerInheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
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ACMG classification
Our verdict: Likely_benign. The variant received -2 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| CHEK2 | NM_007194.4 | c.1216C>T | p.Arg406Cys | missense_variant | Exon 11 of 15 | ENST00000404276.6 | NP_009125.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| CHEK2 | ENST00000404276.6 | c.1216C>T | p.Arg406Cys | missense_variant | Exon 11 of 15 | 1 | NM_007194.4 | ENSP00000385747.1 |
Frequencies
GnomAD3 genomes AF: 0.0000920 AC: 14AN: 152142Hom.: 0 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.0000518 AC: 13AN: 250830 AF XY: 0.0000369 show subpopulations
GnomAD4 exome AF: 0.0000609 AC: 89AN: 1461438Hom.: 0 Cov.: 31 AF XY: 0.0000646 AC XY: 47AN XY: 727062 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000919 AC: 14AN: 152260Hom.: 0 Cov.: 32 AF XY: 0.0000940 AC XY: 7AN XY: 74460 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
not provided Uncertain:6
In the published literature, this variant has been reported in individuals and families with breast/ovarian cancer (PMIDs: 35402282 (2022), 35264596 (2022), 32885271 (2021), 30303537 (2019), 30441849 (2018), 23806170 (2013), 21244692 (2011), 14618615 (2004)), and prostate cancer (PMID: 29368341 (2018)). It has also been observed in breast cancer cases and unaffected control individuals in a large scale breast cancer association study (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared/genes/CHEK2)). In addition, an experimental study reports this variant has a neutral effect on CHEK2 protein function in yeast (PMID: 30851065 (2019)). The frequency of this variant in the general population, 0.00014 (5/35430 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 conflicting predictions that this variant is benign or damaging. Based on the available information, we are unable to determine the clinical significance of this variant. -
The CHEK2 c.1216C>T; p.Arg406Cys variant (rs587782527) is reported in the literature in individuals with breast, ovarian, or prostate cancer (Isaacsson 2018, Le Calvez-Kelm 2011, Osorio 2004, Rashid 2013), and is reported in ClinVar (Variation ID: 142533). This variant is found in the general population with an overall allele frequency of 0.006% (17/282232 alleles) in the Genome Aggregation Database. The arginine at codon 406 is moderately conserved, but computational analyses (SIFT, PolyPhen-2) predict that this variant is tolerated. Additionally, an in vivo yeast-based functional assay suggests that this variant is benign (Delimitsou 2019). However, due to limited information, the clinical significance of this variant is uncertain at this time. REFERENCES Delimitsou A et al. Functional characterization of CHEK2 variants in a Saccharomyces cerevisiae system. Hum Mutat. 2019 May;40(5):631-648. Isaacsson Velho P et al. Intraductal/ductal histology and lymphovascular invasion are associated with germline DNA-repair gene mutations in prostate cancer. Prostate. 2018 Apr;78(5):401-407. Le Calvez-Kelm F et al. Rare, evolutionarily unlikely missense substitutions in CHEK2 contribute to breast cancer susceptibility: results from a breast cancer family registry case-control mutation-screening study. Breast Cancer Res. 2011 Jan 18;13(1):R6. Osorio A et al. The breast cancer low-penetrance allele 1100delC in the CHEK2 gene is not present in Spanish familial breast cancer population. Int J Cancer. 2004 Jan 1;108(1):54-6. Rashid MU et al. Constitutional CHEK2 mutations are infrequent in early-onset and familial breast/ovarian cancer patients from Pakistan. BMC Cancer. 2013 Jun 27;13:312. -
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Published functional studies demonstrate no damaging effect: similar growth rates to the wild-type in a yeast-based assay (Delimitsou et al., 2019); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Not observed at significant frequency in large population cohorts (gnomAD); Observed in individuals with a personal or family history of sarcoma, breast, ovarian, or other cancers (Osorio et al., 2004; Le Calvez-Kelm et al., 2011; Rashid et al., 2013; Ballinger et al., 2016; Girard et al., 2019; Guindalini et al., 2022); Also known as c.1345C>T (p.Arg449Cys); This variant is associated with the following publications: (PMID: 26787654, 23741719, 28514183, 28553140, 25629968, 23806170, 14618615, 27498913, 21244692, 29173497, 28102005, 29368341, 29596542, 30303537, 32322110, 19782031, 22419737, 35495172, 30851065, 35264596) -
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Familial cancer of breast Uncertain:3Benign:1
This variant is considered likely benign. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 25085752]. -
This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 406 of the CHEK2 protein (p.Arg406Cys). This variant is present in population databases (rs587782527, gnomAD 0.01%). This missense change has been observed in individual(s) with breast cancer, hepatoblastoma, and/or ovarian cancer (PMID: 14618615, 21244692, 23806170, 29368341, 32885271, 35402282, 35495172, 35534704, 38061684). ClinVar contains an entry for this variant (Variation ID: 142533). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be tolerated. Experimental studies have shown that this missense change does not substantially affect CHEK2 function (PMID: 30851065). 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. -
This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -
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Hereditary cancer-predisposing syndrome Uncertain:2
This missense variant replaces arginine with cysteine at codon 406 of the CHEK2 protein. Computational prediction suggests that this variant may not impact protein structure and function. A functional study has reported this variant protein as benign in a yeast complementation assay (PMID: 30851065). This variant has been reported in individuals with personal and/or family history of breast and ovarian cancer (PMID: 14618615, 21244692, 23806170, 30441849, 30303537, 32885271, 35402282), prostate cancer (PMID: 29368341), and sarcoma (PMID: 27498913). In a large breast cancer case-control meta analysis conducted by the BRIDGES consortium, this variant was reported in 9/60466 cases and 9/53461 unaffected controls (PMID: 33471991; Leiden Open Variation Database DB-ID CHEK2_000187). This variant has also been identified in 17/282232 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
The p.R406C variant (also known as c.1216C>T), located in coding exon 10 of the CHEK2 gene, results from a C to T substitution at nucleotide position 1216. The arginine at codon 406 is replaced by cysteine, an amino acid with highly dissimilar properties. This variant has been identified in numerous disease cohorts (Osorio A et al. Int. J. Cancer. 2004 Jan;108:54-6; Le Calvez-Kelm F et al. Breast Cancer Res. 2011 Jan;13:R6; Rashid MU et al. BMC Cancer. 2013 Jun;13:312; Ballinger ML et al. Lancet Oncol. 2016 Sep;17:1261-71; Young EL et al. J Med Genet, 2016 06;53:366-76; Decker B et al. J Med Genet, 2017 11;54:732-741; Isaacsson Velho P et al. Prostate. 2018 Apr;78:401-407; Koczkowska M et al. Cancers (Basel), 2018 Nov;10:; Girard E et al. Int J Cancer, 2019 04;144:1962-1974; Lerner-Ellis J et al. J Cancer Res Clin Oncol, 2021 Mar;147:871-879; Abdel-Razeq H et al. Front Oncol, 2022 Mar;12:673094). This alteration behaved as functional in an in vivo, yeast-based growth rate assay (Delimitsou A et al. Hum Mutat, 2019 05;40:631-648). This amino acid position is well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear. -
not specified Uncertain:1
Variant summary: CHEK2 c.1216C>T (p.Arg406Cys) results in a non-conservative amino acid change located in the Serine/Threonine protein kinases, catalytic domain (IPR000719) of the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 5.1e-05 in 254176 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in CHEK2 causing Hereditary Breast And Ovarian Cancer Syndrome (5.1e-05 vs 0.00031), allowing no conclusion about variant significance. However, this observation needs to be cautiously considered since sequence alignment analysis suggests that the variant lies within a region of the gene that has high homology with the CHEK2P2 pseudogene. c.1216C>T has been reported in the heterozygous state in the literature in individuals with personal and/or family history of cancer (e.g. Calvez-Kelm_2011, Rashid_2013, Osorio_2004, Isaacsson_2018, Koczkowska_2018, Girard_2019, Dorling_2021, Guindalini_2022, Stolarova_2023) as well as controls, however segregation data were not found. In a recent large study evaluating breast cancer cases and controls in the Breast Cancer Association Consortium (BCAC), the variant was reported in 9/60466 cases, but was also found in 9/53461 controls (Dorling_2021, reported through LOVD). These report(s) do not provide unequivocal conclusions about association of the variant with CHEK2-related conditions. In a yeast functional study, the variant was found to be benign (Delimitsou_2019), however more relevant functional assays performed in human cell line backgrounds found this variant to be moderately deleterious for both KAP1 phosphorylation and CHEK2 autophosphorylation activity in vitro (example, Stolarova_2023). The following publications have been ascertained in the context of this evaluation (PMID: 21244692, 30851065, 33471991, 30303537, 35264596, 29368341, 30441849, 14618615, 23806170, 37449874). ClinVar contains an entry for this variant (Variation ID: 142533). Based on the evidence outlined above, the variant was classified as VUS-possibly pathogenic. -
CHEK2-related disorder Uncertain:1
The CHEK2 c.1216C>T variant is predicted to result in the amino acid substitution p.Arg406Cys. This variant has been reported in individuals with breast cancer (Osorio et al. 2004. PubMed ID: 14618615; Table S1 - Le Calvez-Kelm et al. 2011. PubMed ID: 21244692; Table S3, Girard et al. 2018. PubMed ID: 30303537; Table S3, Guindalini et al. 2022. PubMed ID: 35264596), an individual with ovarian cancer (Rashid et al. 2013. PubMed ID: 23806170; Table S1, Koczkowska et al. 2018. PubMed ID: 30441849), an individual with prostate cancer (Table S1 - Isaacsson Velho et al. 2018. PubMed ID: 29368341), and an individual with hepatoblastoma (Aguiar et al. 2022. PubMed ID: 35495172). Functional studies found this variant does not differ significantly from wild type CHEK2 (Delimitsou et al. 2019. PubMed ID: 30851065). This variant is reported in 0.014% of alleles in individuals of Latino descent in gnomAD (http://gnomad.broadinstitute.org/variant/22-29091741-G-A) and has conflicting interpretations regarding its pathogenicity in ClinVar, ranging from likely benign to uncertain (https://www.ncbi.nlm.nih.gov/clinvar/variation/142533/?new_evidence=true). 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 cancer of breast;C0376358:Prostate cancer;C0585442:Bone osteosarcoma;C5882668:CHEK2-related cancer predisposition Uncertain:1
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Predisposition to cancer Uncertain:1
The CHEK2 c.1216C>T p.(Arg406Cys) missense change has a maximum subpopulation frequency of 0.01% in gnomAD v2.1.1 (https://gnomad.broadinstitute.org). The in silico tool REVEL predicts a benign effect on protein function. This variant was found to be functional in a yeast-based assay (PMID: 30851065). To our knowledge, this variant has not been reported as pathogenic in individuals with CHEK2-related tumors. In summary, the evidence currently available is insufficient to determine the clinical significance of this variant. It has therefore been classified as of uncertain significance. -
Malignant tumor of breast Uncertain:1
The CHEK2 p.Arg406Cys variant was identified in 1 of 290 proband chromosomes (frequency: 0.003) from Pakistani individuals or families with BRCA1/2 negative early-onset and familial breast/ovarian cancers and was not identified in 300 control chromosomes from healthy individuals, or 229 individuals with BRCA1/2 negative breast/ovarian cancers (Rashid 2013). In a yeast complementation assay assessing protein function of the Arg406His variant, the variant did not abrogate CHEK2 function, with yeast cells carrying the Arg406His variant growing at a similar rate to those carrying wildtype (Yilmaz 2014). The variant was also identified in in dbSNP (ID: rs587782527) “With Uncertain significance allele”, ClinVar (classified as uncertain significance by Ambry genetics, GeneDx, Invitae, and Counsyl), Clinvitae; and in control databases in 17 of 276708 chromosomes at a frequency of 0.00006 increasing the likelihood that this may be a low frequency benign variant in certain populations of origin (Genome Aggregation Consortium Feb 27, 2017). The variant was not identified in Cosmic, MutDB, or Zhejiang Colon Cancer Database. The p.Arg406 residue is conserved across mammals and other organisms, and four out of five computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) suggest that the Cys variant may impact the protein; however, this information is not predictive enough to assume pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer, HumanSpliceFinder) 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. -
CHEK2-related cancer predisposition Uncertain:1
This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 406 of the CHEK2 protein (p.Arg406Cys).This amino acid position is moderate conserved (PhyloP=3.6) . This variant is present in population databases (rs587782527, gnomAD 0.01%). This missense change has been observed in individual(s) with breast cancer, hepatoblastoma, and/or ovarian cancer (PMID: 26787654, 23741719, 28514183, 28553140, 25629968, 23806170, 14618615, 27498913, 21244692, 29173497, 28102005, 29368341, 29596542, 30303537, 32322110, 19782031, 22419737, 35495172, 30851065, 35264596). ClinVar contains an entry for this variant (Variation ID: 142533). In addition, the in silico prediction for this alteration is inconclusive. Experimental studies have shown that this missense change does not substantially affect CHEK2 function (PMID: 30851065). 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. Pathogenic/likely pathogenic variants in the CHEK2 gene cause susceptibility to breast cancer (OMIM 114480). -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at