Sohela Shah

A recurrent germline PAX5 mutation confers susceptibility to pre-B cell acute lymphoblastic leukemia

Somatic alterations of the lymphoid transcription factor gene PAX5 (also known as BSAP) are a hallmark of B cell precursor acute lymphoblastic leukemia (B-ALL), but inherited mutations of PAX5 have not previously been described. Here we report a new heterozygous germline variant, c.547G>A (p.Gly183Ser), affecting the octapeptide domain of PAX5 that was found to segregate with disease in two unrelated kindreds with autosomal dominant B-ALL. Leukemic cells from all affected individuals in both families exhibited 9p deletion, with loss of heterozygosity and retention of the mutant PAX5 allele at 9p13. Two additional sporadic ALL cases with 9p loss harbored somatic PAX5 substitutions affecting Gly183. Functional and gene expression analysis of the PAX5 mutation demonstrated that it had significantly reduced transcriptional activity. These data extend the role of PAX5 alterations in the pathogenesis of pre-B cell ALL and implicate PAX5 in a new syndrome of susceptibility to pre-B cell neoplasia.

Rare variants in XRCC2 as breast cancer susceptibility alleles

Background Recently, rare germline variants in XRCC2 were detected in non-BRCA1/2 familial breast cancer cases, and a significant association with breast cancer was reported. However, the breast cancer risk associated with these variants needs further evaluation. Methods The coding regions and exon–intron boundaries of XRCC2 were scanned for mutations in an international cohort of 3548 non-BRCA1/2 familial breast cancer cases and 1435 healthy controls using various mutation scanning methods. Predictions on functional relevance of detected missense variants were obtained from three different prediction algorithms. Results The only protein-truncating variant detected was found in a control. Rare non-protein-truncating variants were detected in 20 familial cases (0.6%) and nine healthy controls (0.6%). Although the number of variants predicted to be damaging or neutral differed between prediction algorithms, in all instances these categories were evenly represented among cases and controls. Conclusions Our data do not confirm an association between XRCC2 variants and breast cancer risk, although a relative risk smaller than two could not be excluded. Variants in XRCC2 are unlikely to explain a substantial proportion of familial breast cancer.

Susceptibility Loci Associated with Specific and Shared Subtypes of Lymphoid Malignancies

The genetics of lymphoma susceptibility reflect the marked heterogeneity of diseases that comprise this broad phenotype. However, multiple subtypes of lymphoma are observed in some families, suggesting shared pathways of genetic predisposition to these pathologically distinct entities. Using a two-stage GWAS, we tested 530,583 SNPs in 944 cases of lymphoma, including 282 familial cases, and 4,044 public shared controls, followed by genotyping of 50 SNPs in 1,245 cases and 2,596 controls. A novel region on 11q12.1 showed association with combined lymphoma (LYM) subtypes. SNPs in this region included rs12289961 near LPXN, (PLYM = 3.89×10−8, OR = 1.29) and rs948562 (PLYM = 5.85×10−7, OR = 1.29). A SNP in a novel non-HLA region on 6p23 (rs707824, PNHL = 5.72×10−7) was suggestive of an association conferring susceptibility to lymphoma. Four SNPs, all in a previously reported HLA region, 6p21.32, showed genome-wide significant associations with follicular lymphoma. The most significant association with follicular lymphoma was for rs4530903 (PFL = 2.69×10−12, OR = 1.93). Three novel SNPs near the HLA locus, rs9268853, rs2647046, and rs2621416, demonstrated additional variation contributing toward genetic susceptibility to FL associated with this region. Genes implicated by GWAS were also found to be cis-eQTLs in lymphoblastoid cell lines; candidate genes in these regions have been implicated in hematopoiesis and immune function. These results, showing novel susceptibility regions and allelic heterogeneity, point to the existence of pathways of susceptibility to both shared as well as specific subtypes of lymphoid malignancy.

Rare De Novo Germline Copy-Number Variation in Testicular Cancer

Although heritable factors are an important determinant of risk of early-onset cancer, the majority of these malignancies appear to occur sporadically without identifiable risk factors. Germline de novo copy-number variations (CNVs) have been observed in sporadic neurocognitive and cardiovascular disorders. We explored this mechanism in 382 genomes of 116 early-onset cancer case-parent trios and unaffected siblings. Unique de novo germline CNVs were not observed in 107 breast or colon cancer trios or controls but were indeed found in 7% of 43 testicular germ cell tumor trios; this percentage exceeds background CNV rates and suggests a rare de novo genetic paradigm for susceptibility to some human malignancies.

Assessment of SLX4 Mutations in Hereditary Breast Cancers

Background SLX4 encodes a DNA repair protein that regulates three structure-specific endonucleases and is necessary for resistance to DNA crosslinking agents, topoisomerase I and poly (ADP-ribose) polymerase (PARP) inhibitors. Recent studies have reported mutations in SLX4 in a new subtype of Fanconi anemia (FA), FA-P. Monoallelic defects in several FA genes are known to confer susceptibility to breast and ovarian cancers. Methods and Results To determine if SLX4 is involved in breast cancer susceptibility, we sequenced the entire SLX4 coding region in 738 (270 Jewish and 468 non-Jewish) breast cancer patients with 2 or more family members affected by breast cancer and no known BRCA1 or BRCA2 mutations. We found a novel nonsense (c.2469G>A, p.W823*) mutation in one patient. In addition, we also found 51 missense variants [13 novel, 23 rare (MAF<0.1%), and 15 common (MAF>1%)], of which 22 (5 novel and 17 rare) were predicted to be damaging by Polyphen2 (score = 0.65–1). We performed functional complementation studies using p.W823* and 5 SLX4 variants (4 novel and 1 rare) cDNAs in a human SLX4-null fibroblast cell line, RA3331. While wild type SLX4 and all the other variants fully rescued the sensitivity to mitomycin C (MMC), campthothecin (CPT), and PARP inhibitor (Olaparib) the p.W823* SLX4 mutant failed to do so. Conclusion Loss-of-function mutations in SLX4 may contribute to the development of breast cancer in very rare cases.

Genome sequencing of multiple primary tumors reveals a novel PALB2 variant

Introduction PALB2 (partner and localizer of BRCA2) has been implicated in hereditary breast cancer susceptibility, with estimates of breast cancer risk up to 91% (95% CI, 44% to 100%) to age 70 years for particular mutations. Germline mutations in PALB2 have also been identified in individuals with pancreatic cancer and ovarian carcinoma, both with and without familial breast cancer, suggesting a role in susceptibility to breast and ovarian cancer. PALB2 acts in the double-strand DNA break repair pathway recruiting RAD51 and BRCA2 to DNA breaks via its WD40 domain. Biallelic germline mutations cause Fanconi anemia, complementation group N(FANCN). Pathogenic germline variants of PALB2 causing loss of normal function may be substitutions or insertions/ deletions. Tumors in germline PALB2 mutation carriers show loss of the wild-type allele consistent with a tumor suppressor function. Structural variants deleting or duplicating multiple exons of PALB2 have been reported in association with familial breast cancer and in FANCN, and founder and recurrent mutations in PALB2 have been identified in several populations.

Absence of loss of heterozygosity of BRCA1 in a renal tumor from a BRCA1 germline mutation carrier

BRCA1 functions as a tumor suppressor gene and germline and somatic mutations in this gene have been shown to be associated with many types of cancer. We report the first tumor study of renal cell carcinoma in a carrier of the deleterious BRCA1 mutation-c.68_69delAG.

Abstract 2600: SLX4 mutation in hereditary breast cancer

SLX4 is a DNA repair protein that serves as a docking platform for three structure-specific endonucleases. Recent studies have reported mutations in SLX4 in a new subtype of Fanconi Anemia (FA-P). Monoallelic defects in several Fanconi Anemia genes are known to confer susceptibility to breast and ovarian cancer. Therefore, we resequenced the entire SLX4 coding region in 739 (288 Ashkenazi Jewish and 480 Non-Ashkenazi Jewish) breast cancer patients with 3 or more family members affected by breast cancer and no known BRCA1/BRCA2 mutations, to determine if SLX4 is involved in breast cancer susceptibility. We found a novel nonsense (p.W823*) mutation in one patient. We are sequencing the gene in the breast tumor from the patient to determine the status of the wild-type allele. In addition we also found 8 novel, 33 rare (MAF 0.5) missense variants, of which 12 (5 novel and 10 rare) are predicted as damaging by Polyphen2. Functional analysis of these missense mutations is being performed to determine their role in the pathogenicity of the SLX4 gene. Acknowlegements- This project was funded by The Starr Cancer Consotium (Agata Smorgorzewska and Kenneth Offit), The Rita Allen Foundation Scholars Program Grant (Agata Smorgorzewska) and Burroughs Wellcome Fund Career Award for Medical Scientists (Agata Smorgorzewska). We would like to thank the Geoffrey Beene Translational Oncology and Diagnostic Molecular Genetics laboratories for their help with the study. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2600. doi:1538-7445.AM2012-2600