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ABC system used as an add-on to clarify germline variants previously classified as VUS according to ACMG guidelines

dc.contributor.authorRodrigues, Pedro
dc.contributor.authorTheisen, Patrícia
dc.contributor.authorSilva, Catarina
dc.contributor.authorMendonça, Joana
dc.contributor.authorCarpinteiro, Dina
dc.contributor.authorVieira, Luís
dc.contributor.authorGonçalves, João
dc.date.accessioned2023-11-16T15:15:00Z
dc.date.available2023-11-16T15:15:00Z
dc.date.issued2022-11-28
dc.description.abstractThe increasing number of patients screened by NGS to identify germline variants associated with hereditary breast/ovarian cancer (HBOC) syndromes, is leading to a growing number of variants classified as Variants of Uncertain Significance (VUS) according to ACMG guidelines1. Since the ACMG system merges functional and clinical data into a one-dimensional system, it is not always clear how the classification was obtained. The ABC system (ABCs) of variant classification2 splits functional and clinical grading and aims to give a better guide to variant significance. The main goals of this work were i) to apply the ABCs to a group of previously classified ACMG-VUS and ii) to evaluate the potential clinical impact of this review/classification. Germline variants (36 - 29 missense, 1 synonymous and 6 intronic) detected in 5 genes (BRCA1, BRCA2, ATM, CHEK2, PALB2) previously classified as ACMG-VUS, were selected from our database of patients with HBOC, to be reclassified with the ABCs. Variant assessment included: query of clinical and population databases, literature and in silico tools (VEP, HSF, Alamut, Varsome). Eleven variants were classified as Class 0 (functional - fVUS); 17 as class E (functional - HFE (Hypothetical Function Effect), and 8 as Class D (functional - LFE (Likely Functional Effect). fVUS are not clinically graded. Considering that ACMG-VUS are not actionable, it is still an ongoing debate if they should be reported or not. Since the ACMG merges functional and clinical data, it might be difficult for clinicians to understand how VUS classification is achieved. The ABCs allowed us to distinguish between VUS classified due to lack of data from those that might have a functional impact. Class 0 variants (11) should not be reported and class E (17) reporting is optional. The use of ABCs highlighted 8 variants (class D) which might be a susceptibility factor with functional impact and should be reported. Functional and segregation studies are of major importance to clarify the clinical significance of these variants. 1-PMID: 25741868. 2-PMID: 33981013. Support: FCT/MCTES, ToxOmics and Human Health (UIDB/00009/2020). GenomePT(POCI-01-0145-FEDER-022184).pt_PT
dc.description.sponsorshipFCT/MCTES, ToxOmics and Human Health (UIDB/00009/2020). GenomePT(POCI-01-0145-FEDER-022184).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.urihttp://hdl.handle.net/10400.18/8776
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.relationPOCI-01-0145-FEDER-022184pt_PT
dc.relationCentre for Toxicogenomics and Human Health
dc.subjectVUSpt_PT
dc.subjectACMGpt_PT
dc.subjectVariantpt_PT
dc.subjectBRCA1pt_PT
dc.subjectBRCA2pt_PT
dc.subjectATMpt_PT
dc.subjectCHEK2pt_PT
dc.subjectPALB2pt_PT
dc.subjectDoenças Genéticaspt_PT
dc.subjectGenética Humanapt_PT
dc.titleABC system used as an add-on to clarify germline variants previously classified as VUS according to ACMG guidelinespt_PT
dc.typeconference object
dspace.entity.typePublication
oaire.awardTitleCentre for Toxicogenomics and Human Health
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB%2F00009%2F2020/PT
oaire.citation.conferencePlaceCoimbra, Portugalpt_PT
oaire.citation.title26th Annual Meeting of the Portuguese Society of Human Genetics, 17 November 2022pt_PT
oaire.fundingStream6817 - DCRRNI ID
person.familyNameGonçalves
person.givenNameJoão
person.identifier.ciencia-id5710-1FAE-5FAB
person.identifier.orcid0000-0001-9359-8774
person.identifier.ridL-2265-2014
person.identifier.scopus-author-id55934387500
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typeconferenceObjectpt_PT
relation.isAuthorOfPublication6bbd19e6-ea9c-4502-b972-ec6997e9c481
relation.isAuthorOfPublication.latestForDiscovery6bbd19e6-ea9c-4502-b972-ec6997e9c481
relation.isProjectOfPublicationa438b9d1-8a6a-4c90-a13b-7ccf34071451
relation.isProjectOfPublication.latestForDiscoverya438b9d1-8a6a-4c90-a13b-7ccf34071451

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