PVS1 (moderate): NM_033632.3:c.1922C>G is a nonsense variant (p.Ser641Ter) in the terminal exon that escapes nonsense-mediated decay but truncates the WD40 substrate-recognition domain, a critical functional region of FBXW7.1 PM1 (moderate): The truncation at residue 641 removes C-terminal WD40 repeats within the beta-propeller substrate-recognition domain, a well-characterized critical functional domain of FBXW7.2 PM2 (moderate): The variant is absent from all population databases (gnomAD v2.1, v4.1, gnomAD-Canada), supporting rarity as a pathogenic attribute.3 PP3 (supporting): BayesDel in silico prediction score of 0.655873 supports a pathogenic effect.4 Combined evidence: PVS1 (moderate) + PM1 (moderate) + PM2 (moderate) + PP3 (supporting) = 3 moderate and 1 supporting criterion. Under generic ACMG/AMP 2015 combination rules (PMID:25741868), 3 moderate criteria satisfy the Likely Pathogenic threshold.5