ATM encodes a kinase that acts as a master controller of the cellular DNA damage response: it detects double-strand breaks and coordinates DNA repair, cell cycle arrest, or apoptosis through downstream targets including p53, BRCA1, and CHK2. Loss-of-function mutations in both copies of ATM cause ataxia telangiectasia, an autosomal recessive disorder characterized by neurological problems, immune deficiency, and cancer predisposition. ATM functions as a tumor suppressor: individuals with ataxia telangiectasia are prone to childhood lymphomas, leukemias, and breast cancer, while carriers of a single altered copy have increased risk of breast, pancreatic, prostate, and other cancers. Somatic ATM mutations also occur in lymphoid malignancies and solid tumors, and ATM-deficient cancers are often especially sensitive to DNA-damaging treatments.
This variant
ATM is a tumor suppressor whose loss-of-function causes ataxia-telangiectasia and predisposes carriers to breast, pancreatic, and other cancers. This nonsense change is predicted to eliminate ATM function from the affected allele, placing it squarely in the gene's established loss-of-function disease mechanism and supporting a pathogenic classification.
Transcript
NM_000051.3
HGVS · transcript:coding
NM_000051.3:c.1348G>T
GRCh38
chr11:108250813 G>T
GRCh37
chr11:108121540 G>T
BasisPathogenic under the ClinGen HBOP ATM VCEP v1.5 Rule4: one Very Strong (PVS1) plus two Supporting criteria (PM2, PM5).▾
Pathogenic under the ClinGen HBOP ATM VCEP v1.5 Rule4: one Very Strong (PVS1) plus two Supporting criteria (PM2, PM5).
Classification rationale
PVS1PM2PM5Pathogenic
ATM c.1348G>Tnonsense · exon 10
PVS1 (Very Strong): nonsense change p.(Glu450Ter) predicted to trigger nonsense-mediated decay, upstream of critical ATM domains. PM2 (Supporting): absent from gnomAD v4.1 and v2.1, meeting the 0.001% allele-frequency threshold. PM5 (Supporting): premature termination codon at residue 450, upstream of the VCEP p.Arg3047 truncation threshold. Pathogenic: matches ATM VCEP v1.5 Rule4 (one Very Strong plus two Supporting criteria).
PVS1 + PM2 + PM5→Pathogenic
Gene diagram
· NM_000051.3 · variants mapped to exon structure
ATMNM_000051.3
Fetching transcript structure from UCSC…
Exons
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Transcript span
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Strand
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Variants mapped
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Source
UCSC ncbiRefSeqCurated
All variants in ATM—click a row to locate it on the plot · use the link column to open its page
Variant ↕
Protein
Location
Classification
Link
Applied criteria · 3 applied · 8 assessed
MetEvidence satisfies this criterion.
Not metEvaluated against available evidence; threshold not reached.
Not assessedApplies in principle, but no evidence was found to evaluate it.
N/ADoesn't apply to this variant type.
Applied · 3
Strength Supporting Moderate Strong Very strong
✓
PVS1very strongPathogenic
Met (Very Strong): nonsense change p.(Glu450Ter) at ~15% of the protein is predicted to trigger nonsense-mediated decay, upstream of critical ATM domains.
Case summary normalization: NM_000051.3:c.1348G>T predicts NP_000042.3:p.(Glu450Ter) / p.(E450*), a nonsense variant.pvs1_gene_context.json: ATM has an official CSPEC/VCEP PVS1 decision tree and germline loss-of-function is an established disease mechanism for ATM (lof_mechanism_supported=true, pvs1_gene_gate=eligible).pvs1_variant_assessment.json: consequence_class classified as 'nonsense'; suggested_default_strength 'PVS1' (i.e. full/Very Strong) under the generic PVS1 framework, with the downgrade considerations (NMD escape, non-critical distal region, extreme 3' position) explicitly not triggered here given the early truncation position.
Met (Supporting): absent from gnomAD v4.1 and v2.1, meeting the VCEP's 0.001% allele-frequency threshold.
The ATM VCEP v1.5 specifies PM2 Supporting for frequency <=0.001% in gnomAD v4; the VCEP notes that n=1 in a single subpopulation is sufficiently rare.gnomAD v4.1 reports the variant as absent, which is below the VCEP frequency threshold.The variant is also reported as absent from gnomAD v2.1 and gnomAD-Canada v1.0, providing concordant population-data support.
Met (Supporting): premature termination codon at residue 450 lies upstream of the VCEP's p.Arg3047 truncating-variant threshold.
ATM VCEP v1.5 (cspec) PM5 rule: 'Apply to frameshifting or truncating variants with premature termination codons upstream of p.Arg3047' at Supporting strength.Variant NP_000042.3:p.(Glu450Ter) creates a premature termination codon at residue 450, upstream of the p.Arg3047 cutoff specified by the VCEP.
Assessed · not applied
· 2 not met · 6 not assessed
Pathogenic
PS3Not assessed: insufficient evidence - this variant was not confirmed to have been tested in any VCEP-approved functional assay (Mitui 2009, Barone 2009, Scott 2002).
PS4Not assessed: no case-control enrichment data (odds ratio, confidence interval, or p-value) for this variant was available.
PM3Not assessed: no affected-proband or in-trans evidence with a pathogenic ATM variant was available.
PP1Not assessed: no affected relatives or segregation data were available to support co-segregation.
Benign
BA1Not met: absent from gnomAD v4.1, below the >0.5% BA1 allele-frequency threshold.
BS1Not met: absent from gnomAD v4.1, below the >0.05% BS1 allele-frequency threshold.
BS3Not assessed: insufficient evidence - this variant was not confirmed to have been tested in any VCEP-approved functional assay.
BP2Not assessed: no unaffected-carrier, trans-phase, or co-occurrence observations were available.