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Lim J, Lau S, Bashah NA, Lai K, Wen W, Hasan S, Park D, Pope B, Nguyen-Dumont T, Southey M, Rahman N, Woo Y, Thong M, Ch'ng G, Teo S, Yoon S. Frequency of BRCA1 and BRCA2 Germline Variants in Women With Ovarian Cancer in Malaysia. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.50600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Germline BRCA1 or BRCA2 pathogenic variants in ovarian cancer patients may be informative in risk management and treatment, with the advent of poly(ADP-ribose) polymerase inhibitors. In the era of precision medicine, companion diagnostics for BRCA1 and BRCA2 genes have been featured as a strategy in the Malaysia National Strategic Plan for Cancer Control Program (2016-2020). To facilitate this strategy, frequency data from Malaysia's understudied multiethnic population will be required. Aim: To determine the prevalence of BRCA1 and BRCA2 germline variants in a population-based cohort of ovarian cancer patients in Malaysia. Methods: From August 2016, women with nonmucinous epithelial ovarian, peritoneal or fallopian tube carcinoma are prospectively recruited to the Malaysia-wide population-based MaGiC Observational Study. DNA were tested using a Hi-Plex next generation sequencing method and multiplex ligation-dependent probe amplification to detect < 10 bp alterations and exon deletions or duplications in the BRCA1 and BRCA2 genes. Results: Interim results from 325 patients tested until March 2018 have identified BRCA1 and BRCA2 pathogenic variants in 9.8% (32/325) and 3.1% (10/325) patients, respectively. Variants of uncertain significance were detected in 13.2% (43/325) patients and no pathogenic variants were detected in 73.8% (240/325) patients. Taken together, the frequency of BRCA1/2 pathogenic variants in ovarian cancer patients is approximately 12.9% (42/325). Conclusion: The identification of BRCA1 or BRCA2 carriers across the country have enabled the concentration of efforts from limited genetic counseling resources to high risk families. Results arising from the completion of this study will supplement cancer control programs and genetic services in Malaysia.
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Affiliation(s)
- J. Lim
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - S.Y. Lau
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | | | - K.N. Lai
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - W.X. Wen
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - S.N. Hasan
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - D.J. Park
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - B.J. Pope
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | | | | | - N. Rahman
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - Y.L. Woo
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - M.K. Thong
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - G.S. Ch'ng
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - S.H. Teo
- Cancer Research Malaysia, Subang Jaya, Malaysia
| | - S.Y. Yoon
- Cancer Research Malaysia, Subang Jaya, Malaysia
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Young EL, Feng BJ, Stark AW, Damiola F, Durand G, Forey N, Francy TC, Gammon A, Kohlmann WK, Kaphingst KA, McKay-Chopin S, Nguyen-Dumont T, Oliver J, Paquette AM, Pertesi M, Robinot N, Rosenthal JS, Vallee M, Voegele C, Hopper JL, Southey MC, Andrulis IL, John EM, Hashibe M, Gertz J, Le Calvez-Kelm F, Lesueur F, Goldgar DE, Tavtigian SV. Multigene testing of moderate-risk genes: be mindful of the missense. J Med Genet 2016; 53:366-76. [PMID: 26787654 PMCID: PMC4893078 DOI: 10.1136/jmedgenet-2015-103398] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 12/18/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Moderate-risk genes have not been extensively studied, and missense substitutions in them are generally returned to patients as variants of uncertain significance lacking clearly defined risk estimates. The fraction of early-onset breast cancer cases carrying moderate-risk genotypes and quantitative methods for flagging variants for further analysis have not been established. METHODS We evaluated rare missense substitutions identified from a mutation screen of ATM, CHEK2, MRE11A, RAD50, NBN, RAD51, RINT1, XRCC2 and BARD1 in 1297 cases of early-onset breast cancer and 1121 controls via scores from Align-Grantham Variation Grantham Deviation (GVGD), combined annotation dependent depletion (CADD), multivariate analysis of protein polymorphism (MAPP) and PolyPhen-2. We also evaluated subjects by polygenotype from 18 breast cancer risk SNPs. From these analyses, we estimated the fraction of cases and controls that reach a breast cancer OR≥2.5 threshold. RESULTS Analysis of mutation screening data from the nine genes revealed that 7.5% of cases and 2.4% of controls were carriers of at least one rare variant with an average OR≥2.5. 2.1% of cases and 1.2% of controls had a polygenotype with an average OR≥2.5. CONCLUSIONS Among early-onset breast cancer cases, 9.6% had a genotype associated with an increased risk sufficient to affect clinical management recommendations. Over two-thirds of variants conferring this level of risk were rare missense substitutions in moderate-risk genes. Placement in the estimated OR≥2.5 group by at least two of these missense analysis programs should be used to prioritise variants for further study. Panel testing often creates more heat than light; quantitative approaches to variant prioritisation and classification may facilitate more efficient clinical classification of variants.
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Affiliation(s)
- E L Young
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - B J Feng
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - A W Stark
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - F Damiola
- Breast Cancer Genetics Group, Cancer Research Centre of Lyon, Centre Léon Bérard, Lyon, France
| | - G Durand
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - N Forey
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - T C Francy
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - A Gammon
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - W K Kohlmann
- Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - K A Kaphingst
- Department of Communication and Huntsman Cancer Institute, University of Utah
| | - S McKay-Chopin
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - T Nguyen-Dumont
- Genetic Epidemiology Laboratory, The University of Melbourne, Melbourne, Victoria, Australia
| | - J Oliver
- Instituto de Ciencias Básicas y Medicina Experimental del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - A M Paquette
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - M Pertesi
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - N Robinot
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - J S Rosenthal
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - M Vallee
- Cancer Genomics Laboratory, CHUQ Research Center, Quebec City, Canada
| | - C Voegele
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - J L Hopper
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia Department of Epidemiology (Genome Epidemiology Lab), Seoul National University School of Public Health, Seoul, Korea
| | - M C Southey
- Department of Communication and Huntsman Cancer Institute, University of Utah
| | - I L Andrulis
- Department of Molecular Genetics, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - E M John
- Cancer Prevention Institute of California, Fremont, California, USA Department of Health Research and Policy, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, USA
| | - M Hashibe
- Department of Family and Preventive Medicine, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - J Gertz
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - F Le Calvez-Kelm
- Genetic Cancer Susceptibility group, International Agency for Research on Cancer, Lyon, France
| | - F Lesueur
- Genetic Epidemiology of Cancer Team, Inserm, U900, Institut Curie, Paris, France
| | - D E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
| | - S V Tavtigian
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, USA
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Nguyen-Dumont T, Mahmoodi M, Hammet F, Tran T, Tsimiklis H, Giles GG, Hopper JL, Southey MC, Park DJ. Hi-Plex targeted sequencing is effective using DNA derived from archival dried blood spots. Anal Biochem 2014; 470:48-51. [PMID: 25447460 DOI: 10.1016/j.ab.2014.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 11/28/2022]
Abstract
Many genetic epidemiology resources have collected dried blood spots (predominantly as Guthrie Cards) as an economical and efficient means of archiving sources of DNA, conferring great value to genetic screening methods that are compatible with this medium. We applied Hi-Plex to screen the breast cancer predisposition gene PALB2 in 93 Guthrie Card-derived DNA specimens previously characterized for PALB2 genetic variants via DNA derived from lymphoblastoid cell lines, whole blood, and buffy coat. Of the 93 archival Guthrie Card-derived DNAs, 92 (99%) were processed successfully and sequenced using approximately half of a MiSeq run. From these 92 DNAs, all 59 known variants were detected and no false-positive variant calls were yielded. Fully 98.13% of amplicons (5417/5520) were represented within 15-fold of the median coverage (2786 reads), and 99.98% of amplicons (5519/5520) were represented at a depth of 10 read-pairs or greater. With Hi-Plex, we show for the first time that a High-Plex amplicon-based massively parallel sequencing (MPS) system can be applied effectively to DNA prepared from dried blood spot archival specimens and, as such, can dramatically increase the scopes of both method and resource.
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Affiliation(s)
- T Nguyen-Dumont
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - M Mahmoodi
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - F Hammet
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - T Tran
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - H Tsimiklis
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | | | - G G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria 3004, Australia
| | - J L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Parkville, Victoria 3010, Australia
| | | | - M C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - D J Park
- Genetic Epidemiology Laboratory, Department of Pathology, University of Melbourne, Melbourne, Victoria 3010, Australia.
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Southey MC, Park DJ, Lesueur F, Odefrey F, Nguyen-Dumont T, Hammet F, Neuhausen SL, John EM, Andrulis IL, Chenevix-Trench G, Baglietto L, Le Calvez-Kelm F, Pertesi M, Lonie A, Pope B, Sinilnikova O, Tsimiklis H, Giles GG, Hopper JL, Tavtigian SV, Goldgar DE. Identification of new breast cancer predisposition genes via whole exome sequencing. Hered Cancer Clin Pract 2012. [PMCID: PMC3327171 DOI: 10.1186/1897-4287-10-s2-a40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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