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Germline mutations in cancer predisposition genes among pediatric patients with cancer and congenital anomalies

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Dangoni, Gustavo D. ; Teixeira, Anne Caroline B. ; da Costa, Silvia S. ; Scliar, Marilia O. ; Carvalho, Laura M. L. ; Silva, Luciana N. ; Novak, Estela M. ; Vince, Carolina S. C. ; Maschietto, Mariana C. ; Sugayama, Sofia M. M. ; Odone-Filho, Vicente ; Krepischi, Ana Cristina V.
Total Authors: 12
Document type: Journal article
Source: Pediatric Research; v. 95, n. 5, p. 10-pg., 2024-01-05.
Abstract

BackgroundChildhood cancer has a poorly known etiology, and investigating the underlying genetic background may provide novel insights. A recognized association exists between non-chromosomal birth defects and childhood cancer susceptibility.MethodsWe performed whole-exome sequencing and chromosomal microarray analysis in a cohort of childhood cancer (22 individuals, 50% with congenital anomalies) to unravel deleterious germline variants.ResultsA diagnostic yield of 14% was found, encompassing heterozygous variants in bona fide dominant Cancer Predisposition Genes (CPGs). Considering candidate and recessive CPGs harboring monoallelic variants, which were also deemed to play a role in the phenotype, the yield escalated to 45%. Most of the deleterious variants were mapped in genes not conventionally linked to the patient's tumor type. Relevant findings were detected in 55% of the syndromic individuals, mostly variants potentially underlying both phenotypes.ConclusionWe uncovered a remarkable prevalence of germline deleterious CPG variants, highlighting the significance of a comprehensive genetic analysis in pediatric cancer, especially when coupled with additional clinical signs. Moreover, our findings emphasized the potential for oligogenic inheritance, wherein multiple genes synergistically increase cancer risk. Lastly, our investigation unveiled potentially novel genotype-phenotype associations, such as SETD5 in neuroblastoma, KAT6A in gliomas, JAG1 in hepatoblastomas, and TNFRSF13B in Langerhans cell histiocytosis.ImpactNovel gene-phenotype associations and candidate genes for pediatric cancer were unraveled, such as in gliomas, in neuroblastoma, in hepatoblastomas, and in Langerhans cell histiocytosis.Our analysis revealed a high frequency of deleterious germline variants, particularly in cases accompanied by additional clinical signs, highlighting the importance of a comprehensive genetic evaluation in childhood cancer.Our findings also underscored the potential for oligogenic inheritance in pediatric cancer risk.Understanding the cancer etiology is crucial for genetic counseling, often influencing therapeutic decisions and offering valuable insights into molecular targets for the development of oncological therapies. (AU)

FAPESP's process: 18/21047-9 - Childhood cancer: genetic predisposition and mechanisms of origin
Grantee:Ana Cristina Victorino Krepischi
Support Opportunities: Regular Research Grants
FAPESP's process: 22/03980-5 - GENOMIC AND FUNCTIONAL STUDY OF SYNDROMIC FORMS OF INTELLECTUAL DISABILITY
Grantee:Laura Machado Lara Carvalho
Support Opportunities: Scholarships in Brazil - Post-Doctoral
FAPESP's process: 13/08028-1 - CEGH-CEL - Human Genome and Stem Cell Research Center
Grantee:Mayana Zatz
Support Opportunities: Research Grants - Research, Innovation and Dissemination Centers - RIDC
FAPESP's process: 18/05961-2 - Identification of genetic variants related to cancer predisposition in cohort of patients with embryonal tumors or pediatric tumors and additional clinical signs
Grantee:Anne Caroline Barbosa Teixeira
Support Opportunities: Scholarships in Brazil - Post-Doctoral