Classification of Variants of Reduced Penetrance in High Penetrance Cancer Susceptibility Genes: Framework for Genetics Clinicians and Clinical Scientists by CanVIG-UK (Cancer Variant Interpretation Group-UK)

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Authors
Garrett, A.
Allen, S.
Durkie, M.
Burghel, G. J.
Robinson, R.
Callaway, A.
Field, J.
Frugtniet, B.
Palmer-Smith, S.
Grant, J.
Issue Date
2024-10-24
Type
Journal Article
Language
eng
Keywords
Acmg/amp , Clinical genetics , Framework , Reduced Penetrance , Variant interpretation
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Alternative Title
PURPOSE: Current practice is to report and manage likely pathogenic/pathogenic variants in a given cancer susceptibility gene (CSG) as though having equivalent penetrance, despite increasing evidence of inter-variant variability in risk associations. Using existing variant interpretation approaches, largely based on full-penetrance models, variants where reduced penetrance is suspected may be classified inconsistently and/or as variants of uncertain significance (VUS). We aimed to develop a national consensus approach for such variants within the Cancer Variant Interpretation Group UK (CanVIG-UK) multidisciplinary network. METHODS: A series of surveys and live polls were conducted during and between CanVIG-UK monthly meetings on various scenarios potentially indicating reduced penetrance. These informed the iterative development of a framework for the classification of variants of reduced penetrance by the CanVIG-UK Steering and Advisory Group (CStAG) working group. RESULTS: CanVIG-UK recommendations for amendment of the 2015 ACMG/AMP variant interpretation framework were developed for variants where (A) Active evidence suggests a reduced penetrance effect size (e.g. from case-control or segregation data) (B) Reduced penetrance effect is inferred from weaker/potentially-inconsistent observed data. CONCLUSIONS: CanVIG-UK propose a framework for the classification of variants of reduced penetrance in high-penetrance genes. These principles, whilst developed for CSGs, are potentially applicable to other clinical contexts.
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Citation
Garrett A, Allen S, Durkie M, Burghel GJ, Robinson R, Callaway A, et al. Classification of Variants of Reduced Penetrance in High Penetrance Cancer Susceptibility Genes: Framework for Genetics Clinicians and Clinical Scientists by CanVIG-UK (Cancer Variant Interpretation Group-UK). Genetics in medicine : official journal of the American College of Medical Genetics. 2024:101305.
Publisher
Nature
License
© 2024. Published by Elsevier Inc.
Journal
Genetics in medicine
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