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Title: Novel Germline Mutations in a Cohort of Men with Familial Prostate Cancer.
Austin Authors: Mondschein, Romy;Bolton, Damien M ;Clouston, David;Dowty, James;Kavanagh, Liam;Murphy, Declan;Scott, Prudence;Taylor, Renea A;Thorne, Heather
Affiliation: Department of Physiology and Biomedicine Discovery Institute, Monash University, Melbourne 3800, Australia
The Northern Hospital, Epping 3076, Australia
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Melbourne 3010, Australia
Monash Health Familial Cancer Centre, Clayton 3168, Australia
kConFab, Research Division, Peter MacCallum Cancer Centre, East Melbourne 3002, Australia
TissuPath, Glen Waverley, Melbourne 3150, Australia
Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne 3010, Australia
Issue Date: 26-Jul-2022
Date: 2022
Publication information: Cancers 2022; 14(15)
Abstract: Background: Germline mutations in BRCA2 are associated with aggressive prostate cancer. Additional information regarding the clinical phenotype of germline pathogenic variants in other prostate cancer predisposition genes is required. Clinical testing has been limited by evidence, further restricting knowledge of variants that contribute to prostate cancer development. Objective: Prostate cancer patients who were first- and second-degree relatives from multi-case prostate cancer families underwent a gene panel screen to identify novel (non-BRCA) germline pathogenic variants in cancer predisposition genes and define clinical phenotypes associated with each gene. Methods: The germline genomic DNA (gDNA) of 94 index cases with verified prostate cancer from families with a minimum of two verified prostate cancer cases was screened with an 84-cancer-gene panel. Families were recruited for multi-case breast/ovarian cancer (n = 66), or multi-case prostate cancer (n = 28). Prostate cancer characteristics associated with each gene were compared with prostate cancer cases of confirmed non-mutation carriers (BRCAX), also from multi-case prostate cancer families (n = 111), and with data from the Prostate Cancer Outcomes Registry (PCOR). Results: Ninety-four prostate cancer index cases underwent gene panel testing; twenty-two index cases (22/94; 23%) were found to carry a class 4-5 (C4/5) variant. Six of twenty-two (27%) variants were not clinically notifiable, and seven of twenty-two (31.8%) variants were in BRCA1/2 genes. Nine of twenty-two (40.9%) index cases had variants identified in ATM (n = 4), CHEK2 (n = 2) and HOXB13G84 (n = 3); gDNA for all relatives of these nine cases was screened for the corresponding familial variant. The final cohort comprised 15 confirmed germline mutation carriers with prostate cancer (ATM n = 9, CHEK2 n = 2, HOXB13G84 n = 4). ATM and CHEK2-associated cancers were D'Amico intermediate or high risk, comparable to our previously published BRCA2 and BRCAX prostate cancer cohort. HOXB13G84 carriers demonstrated low- to intermediate-risk prostate cancer. In the BRCAX cohort, 53.2% of subjects demonstrated high-risk disease compared with 25% of the PCOR cohort. Conclusions:ATM and CHEK2 germline mutation carriers and the BRCAX (confirmed non-mutation carriers) cohort demonstrated high risk disease compared with the general population. Targeted genetic testing will help identify men at greater risk of prostate-cancer-specific mortality. Data correlating rare variants with clinical phenotype and familial predisposition will strengthen the clinical validity and utility of these results and establish these variants as significant in prostate cancer detection and management.
DOI: 10.3390/cancers14153623
ORCID: 0000-0002-5145-6783
Journal: Cancers
PubMed URL: 35892882
ISSN: 2072-6694
Type: Journal Article
Subjects: germline
pathogenic variants
prostate cancer
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