Submissions for variant NM_024675.4(PALB2):c.3061G>A (p.Gly1021Arg)

gnomAD frequency: 0.00001  dbSNP: rs143808171

Total submissions: 8

Submitter	RCV	SCV	Clinical significance	Condition	Last evaluated	Review status	Method	Comment
Ambry Genetics	RCV000214675	SCV000274294	uncertain significance	Hereditary cancer-predisposing syndrome	2023-10-06	criteria provided, single submitter	clinical testing	The p.G1021R variant (also known as c.3061G>A), located in coding exon 10 of the PALB2 gene, results from a G to A substitution at nucleotide position 3061. The glycine at codon 1021 is replaced by arginine, an amino acid with dissimilar properties. This alteration was identified in 1/1240 probands from the Breast Cancer Family Registry who had previously screened negative for BRCA1 and BRCA2 mutations (Nguyen-Dumont T et al. Breast Cancer Res. Treat., 2015 Jan;149:547-54). This alteration was also found to be functional in a homology-directed DNA repair (HDR) assay (Wiltshire T et al. Genet. Med., 2020 Mar;22:622-632). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear.
Labcorp Genetics (formerly Invitae), Labcorp	RCV000558947	SCV000633401	uncertain significance	Familial cancer of breast	2024-01-26	criteria provided, single submitter	clinical testing	This sequence change replaces glycine, which is neutral and non-polar, with arginine, which is basic and polar, at codon 1021 of the PALB2 protein (p.Gly1021Arg). This variant is present in population databases (rs143808171, gnomAD 0.002%). This missense change has been observed in individual(s) with a personal and/or family history of breast cancer (PMID: 25575445, 35610400). ClinVar contains an entry for this variant (Variation ID: 230665). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt PALB2 protein function with a positive predictive value of 80%. Experimental studies have shown that this missense change does not substantially affect PALB2 function (PMID: 31636395). In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance.
Counsyl	RCV000558947	SCV000785161	uncertain significance	Familial cancer of breast	2017-05-10	criteria provided, single submitter	clinical testing
Color Diagnostics, LLC DBA Color Health	RCV000214675	SCV001735673	uncertain significance	Hereditary cancer-predisposing syndrome	2022-07-26	criteria provided, single submitter	clinical testing	This missense variant replaces glycine with arginine at codon 1021 of the PALB2 protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). A functional study has shown the mutant protein to exhibit 80% of wild-type activity in a homology-directed repair assay (PMID: 31636395). This variant has been reported in an individual affected with pancreatic cancer (PMID: 33127389). This variant has been identified in 2/251450 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance.
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario	RCV001798715	SCV002043597	uncertain significance	Breast and/or ovarian cancer	2020-01-10	criteria provided, single submitter	clinical testing
Women's Health and Genetics/Laboratory Corporation of America, LabCorp	RCV002265691	SCV002547576	uncertain significance	not specified	2022-05-19	criteria provided, single submitter	clinical testing	Variant summary: PALB2 c.3061G>A (p.Gly1021Arg) results in a non-conservative amino acid change located in the WD40 domain (IPR031920) of the encoded protein sequence. Four of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 8e-06 in 251450 control chromosomes (gnomAD). The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.3061G>A has been reported in the literature in an individual (who was negative for BRCA1 and BRCA2 mutations) with a personal and/or family history of breast cancer (Nguyen-Dumont_2015). This report does not provide unequivocal conclusions about association of the variant with Hereditary Breast and Ovarian Cancer Syndrome. Co-occurrence with another pathogenic variant has been found in an internal LCA sample (CHEK2 c.1100delC, (p.Thr367MetfsX15)), providing supporting evidence for a benign role. At least one publication reported experimental evidence evaluating an impact on protein function, and demonstrated this missense change did not significantly affect PALB2 function in in a homology-directed DNA repair (HDR) assay (Wiltshire_2019). Five clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as VUS-possibly benign.
Myriad Genetics, Inc.	RCV000558947	SCV004019168	likely benign	Familial cancer of breast	2023-03-30	criteria provided, single submitter	clinical testing	This variant is considered likely benign. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 25085752].
GeneDx	RCV003328567	SCV004035894	uncertain significance	not provided	2023-09-13	criteria provided, single submitter	clinical testing	Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Published functional studies suggest an intermediate effect on homology-directed repair (HDR) activity (Wiltshire et al., 2020); Observed in individuals with a personal and family history suggestive of hereditary breast and ovarian cancer (Nguyen-Dumont et al., 2015; Gonzalez et al., 2022); This variant is associated with the following publications: (PMID: 25575445, 31636395, 33195396, 35610400)