POLE c.1735C>T, p.Arg579Cys

NM_006231.4:c.1735C>T
COSM2001748

Classification Summary

Variant of Uncertain Significance (VUS)

R579C in POLE is classified as VUS. The variant is extremely rare (PM2) and lies at a residue with another pathogenic missense change (PM5), but in silico evidence suggests benign impact (BP4). No additional supporting or contradictory evidence is available, leaving insufficient data for definitive classification.

Population Frequency
0.00398%
Low Frequency
ClinVar Classification
Uncertain Significance (VUS)
2 publications
REVEL Score
0.241
Uncertain (Low)
COSMIC Recurrence
1 occurrences
No Criteria Applied
Classification Evidence
Very Strong (PVS)
None applied
Strong (PS/BS)
None applied
Moderate (PM/BA)
PM2 PM5
Supporting (PP/BP)
BP4
Created: 2025-05-15T11:34:41.160333

Genetic Information

Gene & Transcript Details
Gene
POLE
Transcript
NM_006231.4 MANE Select
Total Exons
49
Strand
Reverse (−)
Reference Sequence
NC_000012.11
Alternative Transcripts
ID Status Details
NM_006231.2 Alternative 49 exons | Reverse
NM_006231.3 RefSeq Select 49 exons | Reverse
Variant Details
HGVS Notation
NM_006231.4:c.1735C>T
Protein Change
R579C
Location
Exon 16 (Exon 16 of 49)
16
5' Exon Structure (49 total) 3'
Functional Consequence
Loss of Function
Related Variants
ClinVar reports other pathogenic variants at position 579: R579H
Alternate Identifiers
COSM2001748
Variant interpretation based on transcript NM_006231.4

Clinical Evidence

Population Frequency
Global Frequency
0.00398%
Rare
Highest in Population
Remaining individuals
0.0163%
Low Frequency
Global: 0.00398%
Remaining individuals: 0.0163%
0%
0.0005%
0.001%
0.01%
0.05%
1%+
Allele Information
Total: 251482 Alt: 10 Homozygotes: 0
ACMG Criteria Applied
PM2
This variant is present in gnomAD (MAF= 0.00398%, 10/251482 alleles, homozygotes = 0) and at a higher frequency in the Remaining individuals population (MAF= 0.0163%, 1/6140 alleles, homozygotes = 0). The variant is rare (MAF < 0.1%), supporting PM2 criterion application.
ClinVar 2025-05-15T11:33:09.141590
Classification
2 publications
Uncertain Significance (VUS)
Based on 5 submitter reviews in ClinVar
Submitter Breakdown
5 VUS
Pathogenic
Likely Pathogenic
VUS
Likely Benign
Benign
Publications
2 publications
Show publication details
Clinical Statement
This variant has been reported in ClinVar as Uncertain significance (5 clinical laboratories).
COSMIC
COSMIC ID
COSM2001748
Recurrence
1 occurrences
PM1 Criteria
Not Applied
Accessing full COSMIC database details requires institutional login or subscription. External links may prompt for authentication.
Functional Domain
Hotspot Status
Not a hotspot
Domain Summary

This variant is not located in a mutational hotspot or critical domain (0 mutations).

Related Variants in This Domain
ClinVar reports other pathogenic variants at position 579: R579H
PM5 criterion applied: Novel missense change at an amino acid residue where a different missense change determined to be pathogenic has been seen before.

Functional Studies

Functional Impact
Summary
The POLE R579C variant has not been functionally characterized, and its biological significance remains unknown.

Computational Evidence

Pathogenicity Predictions
REVEL Score
0.241
0.241
Likely Benign 0.0
Uncertain (Low) 0.2
Uncertain (Med) 0.5
Likely Pathogenic 0.75
REVEL scores ≥ 0.75 are considered strong evidence of pathogenicity (PP3)
Predictor Consensus
Mixed/VUS
PP3 Applied
No
Additional Predictors
Benign:
CADD: 4.10 metasvm: T metalr: T primateai: T
Neutral: Show all
SpliceAI Scores Window: ±500bp
Effect Type Score Position
- Acceptor Loss
0.01
18 bp
- Donor Loss
0.0
306 bp
+ Acceptor Gain
0.0
481 bp
+ Donor Gain
0.01
-293 bp
High impact (≥0.5)
Medium impact (0.2-0.49)
Low impact (<0.2)

VCEP Guidelines

Applied ACMG/AMP Criteria
PVS1
PVS1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PVS1 is: "Null variant in a gene where loss of function (LoF) is a known mechanism of disease (e.g., nonsense, frameshift, canonical ±1 or 2 splice sites, initiation codon, single exon deletion in a LoF gene)". The evidence for this variant shows: R579C is a missense change, not a null variant. Therefore, this criterion is not applied because the variant type does not meet the rule.
PS1
PS1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PS1 is: "Same amino acid change as a known pathogenic variant but different nucleotide change". The evidence for this variant shows: R579C has not been previously established as pathogenic via any nucleotide change. Therefore, this criterion is not applied because there is no prior pathogenic record for this exact amino acid change.
PS2
PS2 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PS2 is: "De novo (both maternity and paternity confirmed) in a patient with the disease and no family history". The evidence for this variant shows: no information on de novo occurrence or parental testing. Therefore, this criterion is not applied due to lack of de novo confirmation.
PS3
PS3 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PS3 is: "Well-established functional studies supportive of a damaging effect on the gene or gene product". The evidence for this variant shows: no functional studies have been reported. Therefore, this criterion is not applied because functional evidence is missing.
PS4
PS4 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PS4 is: "Prevalence in affected individuals significantly increased compared with controls". The evidence for this variant shows: no case–control or burden data are available. Therefore, this criterion is not applied due to lack of case enrichment data.
PM1
PM1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PM1 is: "Located in a mutational hot spot or well-established functional domain without benign variation". The evidence for this variant shows: no data indicating that R579 lies in a known hotspot or critical domain devoid of benign variation. Therefore, this criterion is not applied.
PM2
PM2 (Moderate)
According to standard ACMG guidelines, the rule for PM2 is: "Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes Project, or Exome Aggregation Consortium". The evidence for this variant shows: MAF=0.00398% in gnomAD with no homozygotes observed, indicating extreme rarity. Therefore, this criterion is applied at Moderate strength because the variant is absent or at extremely low frequency in population databases.
PM3
PM3 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PM3 is: "Detected in trans with a pathogenic variant (for recessive disorders)". The evidence for this variant shows: no information on trans phase with another variant. Therefore, this criterion is not applied due to lack of phasing data.
PM4
PM4 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PM4 is: "Protein length changes due to in-frame deletions/insertions or stop-loss variants". The evidence for this variant shows: R579C is a missense change without protein length alteration. Therefore, this criterion is not applied.
PM5
PM5 (Moderate)
According to standard ACMG guidelines, the rule for PM5 is: "Novel missense change at an amino acid residue where a different pathogenic missense change has been seen". The evidence for this variant shows: another missense at residue R579 has been reported as pathogenic. Therefore, this criterion is applied at Moderate strength because a different pathogenic missense change at the same residue has been observed.
PM6
PM6 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PM6 is: "Assumed de novo, but without confirmation of paternity and maternity". The evidence for this variant shows: no de novo assumption data. Therefore, this criterion is not applied.
PP1
PP1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PP1 is: "Co-segregation with disease in multiple affected family members". The evidence for this variant shows: no segregation data in families. Therefore, this criterion is not applied.
PP2
PP2 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PP2 is: "Missense variant in a gene with a low rate of benign missense variation and where missense variants are a common mechanism of disease". The evidence for this variant shows: POLE does have missense variants but no clear low benign missense rate data. Therefore, this criterion is not applied.
PP3
PP3 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PP3 is: "Multiple lines of computational evidence support a deleterious effect on the gene/gene product (e.g., conservation, splicing impact)". The evidence for this variant shows: in silico tools give predominantly benign or mixed predictions and SpliceAI predicts no splicing impact. Therefore, this criterion is not applied because computational evidence does not support deleterious effect.
PP4
PP4 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PP4 is: "Patient's phenotype or family history highly specific for a disease with a single genetic etiology". The evidence for this variant shows: no patient clinical phenotype or family history provided. Therefore, this criterion is not applied.
PP5
PP5 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for PP5 is: "Reputable source reports variant as pathogenic, but without accessible evidence". The evidence for this variant shows: ClinVar classifies it as VUS. Therefore, this criterion is not applied.
BA1
BA1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BA1 is: "Allele frequency is too high for the disorder (based on population data)". The evidence for this variant shows: MAF=0.00398%, which is far below the >5% threshold. Therefore, this criterion is not applied.
BS1
BS1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BS1 is: "Allele frequency is greater than expected for the disorder". The evidence for this variant shows: frequency is extremely low and not greater than expected. Therefore, this criterion is not applied.
BS2
BS2 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BS2 is: "Observed in healthy individuals with full penetrance expected at an early age". The evidence for this variant shows: no healthy adult carrier data. Therefore, this criterion is not applied.
BS3
BS3 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BS3 is: "Well-established functional studies show no damaging effect on protein function or splicing". The evidence for this variant shows: no functional studies. Therefore, this criterion is not applied.
BS4
BS4 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BS4 is: "Lack of segregation in affected family members". The evidence for this variant shows: no segregation data. Therefore, this criterion is not applied.
BP1
BP1 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP1 is: "Missense variant in a gene where only LoF causes disease". The evidence for this variant shows: POLE disease mechanism includes both missense and LoF variants. Therefore, this criterion is not applied.
BP2
BP2 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP2 is: "Observed in trans with a pathogenic variant for dominant disorders or in cis with a pathogenic variant". The evidence for this variant shows: no phasing or cis/trans information. Therefore, this criterion is not applied.
BP3
BP3 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP3 is: "In-frame deletions/insertions in a repetitive region without known function". The evidence for this variant shows: R579C is a missense, not an in-frame indel. Therefore, this criterion is not applied.
BP4
BP4 (Supporting)
According to standard ACMG guidelines, the rule for BP4 is: "Multiple lines of computational evidence suggest no impact on gene or gene product (conservation, evolutionary, splicing impact, etc.)". The evidence for this variant shows: in silico predictors (CADD, MetaSVM, MetaLR, PrimateAI, REVEL) suggest benign impact and SpliceAI predicts no splicing effect. Therefore, this criterion is applied at Supporting strength because computational evidence indicates no deleterious impact.
BP5
BP5 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP5 is: "Variant found in a case with an alternate molecular basis for disease". The evidence for this variant shows: no alternate molecular basis reported. Therefore, this criterion is not applied.
BP6
BP6 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP6 is: "Reputable source reports variant as benign, but without accessible evidence". The evidence for this variant shows: ClinVar reports VUS, not benign. Therefore, this criterion is not applied.
BP7
BP7 (Not Applied) Strength Modified
According to standard ACMG guidelines, the rule for BP7 is: "Synonymous variant with no predicted impact on splicing". The evidence for this variant shows: R579C is missense, not synonymous. Therefore, this criterion is not applied.