Submissions for variant NM_007294.4(BRCA1):c.5509T>G (p.Trp1837Gly)

dbSNP: rs80356959

Total submissions: 8

Submitter	RCV	SCV	Clinical significance	Condition	Last evaluated	Review status	Method	Comment
ClinGen ENIGMA BRCA1 and BRCA2 Variant Curation Expert Panel, ClinGen	RCV004566895	SCV004101429	pathogenic	BRCA1-related cancer predisposition	2024-06-11	reviewed by expert panel	curation	The c.5509T>G variant in BRCA1 is a missense variant predicted to cause substitution of Tryptophan by Glycine at amino acid 1837 (p.Trp1837Gly). This variant is absent from gnomAD v2.1 (exomes only, non-cancer subset, read depth >=25) and gnomAD v3.1 (non-cancer subset, read depth >=25) (PM2_Supporting met). This BRCA1 missense variant is within a key functional domain and the computational predictor BayesDel (noAF) gives a score of 0.533, above the recommended threshold of 0.28 for prediction of impact on BRCA1 function via protein change. SpliceAI predictor score of 0.00 suggests that the variant has no impact on splicing (score threshold <0.10) (PP3 met). Reported by three calibrated studies with discordant results. Exhibits protein function similar to pathogenic control variants (PMIDs: 30209399, 30765603) and between what was observed for benign and pathogenic control variants (PMID: 30257991) (PS3 and BS3 not met). Multifactorial likelihood ratio analysis using clinically calibrated data produced a combined LR for this variant of 2004.67 (based on Co-occurrence LR=1.067; Family History LR=1878.3), above the threshold for very strong evidence towards pathogenicity (>350) (PP4_Very strong met; PMIDs: 17924331, 31853058). In summary, this variant meets the criteria to be classified as a Pathogenic variant for BRCA1-related cancer predisposition based on the ACMG/AMP criteria applied as specified by the ENIGMA BRCA1/2 VCEP (PM2_Supporting, PP3, PP4_Very strong).
Ambry Genetics	RCV000130013	SCV000184838	pathogenic	Hereditary cancer-predisposing syndrome	2023-11-20	criteria provided, single submitter	clinical testing	The p.W1837G variant (also known as c.5509T>G), located in coding exon 22 of the BRCA1 gene, results from a T to G substitution at nucleotide position 5509. The tryptophan at codon 1837 is replaced by glycine, an amino acid with highly dissimilar properties. This alteration is located in the BRCT domain of BRCA1. The tandem BRCA1 BRCT domain-phosphopeptide complex is involved in the DNA damage response in BRCA1 and alterations in this region which result in loss of phosphopeptide binding or weak binding abrogate BRCA1-BACH1 interaction and are responsible for cancer predisposition (Clapperton JA et al. Nat Struct Mol Biol. 2004 Jun;11(6):512-8). A peptide binding assay demonstrated that the p.W1837G alteration shows no detectable binding to biotinylated pSer-X-X-Phe peptides (Williams RS et al. Nat Struct Mol Biol. 2004 Jun;11(6):519-25). This alteration is structurally destabilizing and would result in a void within the BRCT domain (Williams RS et al. Nat Struct Mol Biol. 2004 Jun;11(6):519-25). A thermodynamic protein stability assay demonstrated that this alteration did not result in a stable protein but, rather, resulted in inclusion bodies, and was, in fact, classified as &ldquo;very destabilizing&rdquo; (Rowling PJ et al. J Biol Chem. 2010 Jun 25;285(26):20080-7). One functional study found that this nucleotide substitution is non-functional in a high throughput genome editing haploid cell survival assay (Findlay GM et al. Nature, 2018 Oct;562:217-222). In addition, other functional assays confirm that the alteration is destabilizing and may cause a folding defect and predict a moderate functional impact that may increase cancer risk (Glover JN et al. Fam Cancer. 2006;5(1):89-93; Lee MS et al. Cancer Res. 2010 Jun 15;70(12):4880-90). Another alteration at the same codon, p.W1837R, has been described in individuals with personal and/or family histories consistent with hereditary breast and ovarian cancer (HBOC) syndrome (Montagna M et al. Cancer Res. 1996;56:5466-9; Fernandes GC et al. Oncotarget. 2016 Dec;7:80465-80481), and has also been predicted to be likely pathogenic and deleterious in several functional studies (Williams RS et al. J. Biol. Chem. 2003; 278:53007-16; Abkevich V et al. J. Med. Genet. 2004;41:492-507; Mirkovic N et al. Cancer Res. 2004 Jun;64:3790-7; Karchin R et al. PLoS Comput. Biol. 2007;3:e26; Lee MS et al. Cancer Res. 2010;70:4880-90; Bouwman P et al. Cancer Discov. 2013 Oct;3(10):1142-55; Gaiser OJ et al. Biochemistry. 2004 Dec;43:15983-95). Of note, this alteration is also designated as 5628T>G in published literature. This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation.
Invitae	RCV001380439	SCV001578519	pathogenic	Hereditary breast ovarian cancer syndrome	2023-01-16	criteria provided, single submitter	clinical testing	For these reasons, this variant has been classified as Pathogenic. This variant disrupts the p.Trp1837 amino acid residue in BRCA1. Other variant(s) that disrupt this residue have been determined to be pathogenic (PMID: 8968102, 11802209, 15689452, 27741520, 28324225). This suggests that this residue is clinically significant, and that variants that disrupt this residue are likely to be disease-causing. Experimental studies have shown that this missense change affects BRCA1 function (PMID: 14534301, 15133503, 20378548, 20516115, 30209399). Advanced modeling performed at Invitae incorporating data from internal and/or published experimental studies (PMID: 30209399) indicates that this missense variant is expected to disrupt BRCA1 function. ClinVar contains an entry for this variant (Variation ID: 55607). This missense change has been observed in individual(s) with clinical features of BRCA1-related conditions (PMID: 16267036). This variant is not present in population databases (gnomAD no frequency). This sequence change replaces tryptophan, which is neutral and slightly polar, with glycine, which is neutral and non-polar, at codon 1837 of the BRCA1 protein (p.Trp1837Gly).
Baylor Genetics	RCV000112688	SCV004216879	likely pathogenic	Breast-ovarian cancer, familial, susceptibility to, 1	2024-02-20	criteria provided, single submitter	clinical testing
All of Us Research Program, National Institutes of Health	RCV000112688	SCV004833986	likely pathogenic	Breast-ovarian cancer, familial, susceptibility to, 1	2023-07-19	criteria provided, single submitter	clinical testing	This missense variant replaces tryptophan with glycine at codon 1837 of the BRCA1 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Functional studies have reported that this variant abolishes BRCA1 function in phosphopeptide binding, transcription activation, and in a haploid cell proliferation assay, as well as disrupts the folding of the BRCT domain (PMID: 15133503, 20378548, 20516115, 29884841, 30209399). This variant has been reported in individuals who underwent BRCA gene testing (PMID: 10923033, 16267036). Different missense substitutions at this codon have been reported as disease-causing in ClinVar (variation ID: 37679, 37680, 853483, 1065962), and p.Trp1837Arg specifically has been reported in individuals and families affected with breast cancer and reported to segregate with disease in a family (PMID: 8968102, 11802209, 27741520, 28324225). This variant has not been identified in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic.
Breast Cancer Information Core (BIC) (BRCA1)	RCV000112688	SCV000145557	uncertain significance	Breast-ovarian cancer, familial, susceptibility to, 1	2002-06-20	no assertion criteria provided	clinical testing
Department of Pathology and Laboratory Medicine, Sinai Health System	RCV000499847	SCV000591637	likely pathogenic	Malignant tumor of breast		no assertion criteria provided	clinical testing	The BRCA1 p.Trp1837Gly variant was identified in the literature in at least one individual referred for BRCA1 and BRCA2 testing at Myriad Genetic Laboratories (Judkins 2005). The variant was also identified in dbSNP (ID: rs80356959) “With Likely pathogenic, Uncertain significance allele”, HGMD, the ClinVar database (submitted by Ambry Genetics with a classification of uncertain significance; submitted by Invitae with no classification provided), the BIC database (1X with unknown clinical importance), and UMD (1X as an unclassified variant). The variant is located at a BRCT fold position, within the alpha helix of the C-terminal portion of the BRCA1 protein. Several in vitro studies have shown a deleterious effect of the variant on the protein structure and function, with it having a strong destabilizing effect (Glover 2006, Lee 2010, Rowling 2010, Williams 2003), compromised transcriptional activity (Lee 2010 20516115), and reduced peptide binding activity and specificity (Glover 2006, Lee 2010, Williams 2004). The p.Trp1837 residue is conserved across mammals and lower organisms, and computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) suggest that the p.Trp1837Gly variant may impact the protein. In addition, in silico studies using protein structure-based assessment or evolutionary conservation analysis predict the variant to have a deleterious effect (Abkevich 2004, Karchin 2007, Mirkovic 2004, Williams 2003). In summary, based on the above information, the clinical significance of this variant cannot be determined with certainty at this time although we would lean towards a more pathogenic role for this variant. This variant is classified as predicted pathogenic.
Brotman Baty Institute, University of Washington	RCV000112688	SCV001243484	not provided	Breast-ovarian cancer, familial, susceptibility to, 1		no assertion provided	in vitro