rs730881684
Variant summary
Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM1PM2PP3_Moderate
The NM_007194.4(CHEK2):c.503C>T(p.Thr168Ile) variant causes a missense change. The variant allele was found at a frequency of 0.00000186 in 1,613,924 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_007194.4 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
Frequencies
GnomAD3 genomes AF: 0.00000657 AC: 1AN: 152118Hom.: 0 Cov.: 32
GnomAD4 exome AF: 0.00000137 AC: 2AN: 1461806Hom.: 0 Cov.: 32 AF XY: 0.00 AC XY: 0AN XY: 727208
GnomAD4 genome AF: 0.00000657 AC: 1AN: 152118Hom.: 0 Cov.: 32 AF XY: 0.0000135 AC XY: 1AN XY: 74298
ClinVar
Submissions by phenotype
Familial cancer of breast Uncertain:5
- -
This sequence change replaces threonine, which is neutral and polar, with isoleucine, which is neutral and non-polar, at codon 168 of the CHEK2 protein (p.Thr168Ile). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with breast and ovarian cancer or male breast cancer (PMID: 31050813, 31409080, 35264596). ClinVar contains an entry for this variant (Variation ID: 182427). 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 disruptive. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on CHEK2 function (PMID: 31050813, 31409080, 37449874). 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 variant is classified as a variant of uncertain significance as there is insufficient evidence to determine its impact on protein function and/or cancer risk. -
- -
Hereditary cancer-predisposing syndrome Uncertain:2
The p.T168I variant (also known as c.503C>T), located in coding exon 3 of the CHEK2 gene, results from a C to T substitution at nucleotide position 503. The threonine at codon 168 is replaced by isoleucine, an amino acid with similar properties. This variant was functional in an in vitro kinase assay but non-functional in a human cell-based kinase assay also measuring KAP1 phosphorylation (Kleiblová P et al. Klin Onkol, 2019;32:36-50). This alteration was detected in a cohort of 1663 Brazilian breast cancer patients who underwent hereditary multigene panel testing (Guindalini RSC et al. Sci Rep, 2022 Mar;12:4190). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
This missense variant replaces threonine with isoleucine at codon 168 of the CHEK2 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Functional studies report conflicting results regarding the impact of this variant on CHEK2 phosphorylation activity (PMID: 31050813, 37449874). This variant has been reported in individuals affected with breast cancer (PMID: 31050813, 37449874) and in an unaffected individual (PMID: 33471991; Leiden Open Variation Database DB-ID CHEK2_000524). This variant has not been identified 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. -
Li-Fraumeni syndrome 2 Pathogenic:1
Variant summary: CHEK2 c.503C>T results in the replacement of Thr168 by an Ile residue (p.Thr168Ile). The variant was identified in 1 out of 396 patients analysed (freq: 0.0025, doi: 10.3389/fgene.2023.1274108). The patient was a man that developed breast cancer at the age of 57 (luminal-Her2+ tumor phenotype). A co-segregation study was done, showing that the mother and one sister developed breast cancer (BC) at the age of 72 and 64 years, respectively, and that an aunt (by the father side) developed BC at the age of 40 years. The variant was checked in the affected proband's sister, but results showed she did not carry the genetic alteration. A second sister that has not developed BC does carry the mutation. These facts prevents clearly establishing the Thr168Ile variant as a predisposition factor for BC from this study. Moreover, Thr168 appears well conserved in vertebrate species, and the replacement of a threonine by an isoleucine represents the introduction of a bulkier residue. Thr168 is located in the FHA domain, its side chain appears buried forming an apparently stabilizing local H-bond network with Asp162, Ser164, and His143, and is far from any other domain or the dimeric surface. Our in-silico study on the protein stability based on relaxation molecular dynamics simulations (doi: 10.3389/fgene.2023.1274108) indicates that Thr168Ile reduces the conformational stability of CHEK2 protein. The variant does not appear reported in gnomAD v4. Other replacements at the same position (T168N, T168P, and T168A) appear classified in ClinVar as of Uncertain Significance. However, functional studies (PMID: 31050813, 31409080) have reported impaired kinase activity for CHEK2. The metapredictor PirePred (relies on verdicts from other 15 predictor or metapredictor tools) classifies Thr168Ile as Pathogenic, whereas the AI-based predictor AlphaMissense and the ACMG classification tool Franklin suggests this variant as Likely Pathogenic. All this information, even if not conclusive, appears to indicate this variant have more chances of being Pathogenic. -
Breast and/or ovarian cancer Pathogenic:1
- -
not provided Uncertain:1
Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Observed in individuals with breast (male or female) and/or ovarian cancer, including one patient who also harbored a pathogenic variant in BRCA2 (Kleiblova et al., 2019; Guindalini et al., 2022); Published functional studies suggest a damaging effect: impaired kinase activity (Kleiblova et al., 2019); This variant is associated with the following publications: (PMID: 22419737, 19782031, 31409080, 31050813, 35264596) -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at