Challenging interpretation of germline TP53 variants based on the experience of a national comprehensive cancer centre

Author:

Butz HenriettORCID,Bozsik Anikó,Grolmusz Vince,Szőcs Erika,Papp János,Patócs Attila

Abstract

AbstractTP53 variant interpretation is still challenging, especially in patients with attenuated Li–Fraumeni syndrome (LFS). We investigated the prevalence of pathogenic/likely pathogenic (P/LP) variants and LFS disease in the Hungarian population of cancer patients. By testing 893 patients with multiplex or familial cancer, we identified and functionally characterized novel splice variants of TP53 helping accurate variant classification. The differences among various semi-automated interpretation platforms without manual curation highlight the importance of focused interpretation as the automatic classification systems do not apply the TP53-specific criteria. The predicted frequency of the TP53 P/LP variants in Hungary is 0.3 per million which most likely underestimates the real prevalence. The higher detection rate of disease-causing variants in patients with attenuated LFS phenotype compared to the control population (OR 12.5; p < 0.0001) may raise the potential benefit of the TP53 genetic testing as part of the hereditary cancer panels of patients with multiple or familial cancer even when they do not meet Chompret criteria. Tumours developed at an earlier age in phenotypic LFS patients compared to the attenuated LFS patients which complicates genetic counselling as currently there are no different recommendations in surveillance protocols for LFS, phenotypic LFS, and attenuated LFS patients.

Funder

National Research, Development and Innovation Office

New National Excellence Program of the Ministry of Human Capacities

Hungarian Academy of Sciences

National Laboratories Excellence program under the National Tumor Biology Laboratory project

National Institute of Oncology

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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