Publications
Clinical Significance of Gene-Specific ACMG/AMP Classification: A Single-Center Retrospective Analysis of BRCA1 and BRCA2 Variants of Uncertain Significance Using ClinGen ENIGMA Expert Panel Guideline
Abstract
Introduction: Identifying variants in the hereditary cancer genes is crucial for diagnosis, treatment and follow-up of cancer patients. However, many genetic variants detected in these genes are classified as “variants of uncertain significance (VUS)”, which often creates significant challenges for patient management. The study aims to reclassify the VUS reported in BRCA1/2 genes according to the gene-specific guideline, thereby improving clinical interpretation. Materials-Methods: In this study, we retrospectively analyzed the results of hereditary cancer panel testing conducted on 1,614 patients between December 2022 and December 2023. Among these patients, in the BRCA1 and BRCA2 genes, a total of 132 VUS were identified. These VUS were reclassified in accordance with the ClinGen ENIGMA Expert Panel Guideline. Results: Following reclassification based on the ClinGen ENIGMA Expert Panel Guideline, 56.8% (n=75) of the 132 VUS were reclassified as likely benign, 10.6% (n=14) benign, 31.8% (n=42) VUS, and 0.8% (n=1) as likely pathogenic. Discussion: The reclassification of 132 VUS in the BRCA1 and BRCA2 genes, according to the ClinGen ENIGMA Expert Panel Guideline, suggests that standardized and evidence-based criteria may help reduce uncertainty in variant interpretation. A notable proportion of the variants (67.4%) were reclassified as likely benign or benign, consistent with rates reported in the literature. Despite these findings, 31.8% of the variants remained classified as VUS, emphasizing the need for additional functional studies and further data integration to improve classification accuracy. The identification of one likely pathogenic variant illustrates the potential of these guidelines to recognize clinically significant findings. These results highlight how expert-guided approaches could contribute to interpreting BRCA1/BRCA2 variants. However, further validation and research are necessary, alongside the development of population-specific biobank data to incorporate personalized clinical information effectively.
Product Used
NGS
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