Starting
Initialising…
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TP53
Final classification
Likely Pathogenic
TP53 c.716A>G · p.Asn239Ser
TP53

PS3_Strong is met (+4 points): N239S is non-functional in the Kato et al. functional assay and shows loss of function in all three other eligible VCEP assays (Giacomelli, Kotler, Funk), meeting the TP53 VCEP criterion for strong pathogenic functional evidence.

Gene
TP53
Transcript
NM_000546.6
HGVS · transcript:coding
NM_000546.6:c.716A>G
Consequence
N/A
GRCh38
chr17:7674247 T>C
GRCh37
chr17:7577565 T>C
Basis Tavtigian et.al., 2020 - Bayesian adaptation of Richards et.al., 2015 v2.4.0 point-based framework: PS3 strong (+4) + PM2 supporting (+1) + PM5 strong (+4) + BP4 supporting benign (-1) = 8 points, which maps to Likely Pathogenic.
Tavtigian et.al., 2020 - Bayesian adaptation of Richards et.al., 2015 v2.4.0 point-based framework: PS3 strong (+4) + PM2 supporting (+1) + PM5 strong (+4) + BP4 supporting benign (-1) = 8 points, which maps to Likely Pathogenic.
Classification rationale
PS3PM2PM5 BP4 Likely Pathogenic
TP53 c.716A>G

PS3_Strong is met (+4 points): N239S is non-functional in the Kato et al. functional assay and shows loss of function in all three other eligible VCEP assays (Giacomelli, Kotler, Funk), meeting the TP53 VCEP criterion for strong pathogenic functional evidence.1 PM5_Strong is met (+4 points): At codon 239, three different missense variants (N239D, N239I, N239T) have been classified as pathogenic (PS3) by the TP53 VCEP, satisfying the requirement of ≥2 different pathogenic missense variants at the same residue.2 PM2_Supporting is met (+1 point): The variant is extremely rare in population databases (gnomAD v4.1 AF = 6.2e-7), well below the VCEP threshold of <0.00003.3 BP4_Supporting is met (-1 point): Per the VCEP PP3-BP4-codes.xlsx, c.716A>G is assigned BP4. BayesDel score 0.10537 with aGVGD Class C45 and no predicted splicing impact (SpliceAI 0.04).4 Tavtigian point total: 4 (PS3) + 4 (PM5) + 1 (PM2) - 1 (BP4) = 8 points. Under the TP53 VCEP v2.4.0 point-based framework, 6-9 points corresponds to Likely Pathogenic.5 The variant has been observed in ClinVar with majority classification as Likely Pathogenic (6 clinical laboratories) and Pathogenic (1 laboratory), consistent with this adjudication.6 N239S has been reported as a somatic mutation in 56 tumor samples in COSMIC and is classified as Oncogenic (Loss-of-function) by OncoKB, though these somatic data are not directly used for germline criterion points under the VCEP framework.7

PS3 + PM2 + PM5 + BP4 Likely Pathogenic
1 vcep_functional_worksheetPMID:12826609 ↗
2 vcep_functional_worksheet
4 vcep_pp3_bp4_codesbayesdelspliceai ↗
Gene diagram · NM_000546.6 · variants mapped to exon structure
TP53 NM_000546.6
Fetching transcript structure from UCSC…
Applied criteria · 4 met · select any tile
Met
Not met
Not assessed
N/A
Strength very strong supporting
Pathogenic evidence
PVS
PS
PM
PP
Benign evidence
BA
BS
BP
Rationale
Select a criterion.
Sources
Evidence used
    Gaps remaining
      Rule
      Research & evidence
      Population frequency · supports pathogenic
      gnomAD v4.1 screenshot
      gnomAD v4.1
      gnomAD v2.1 screenshot
      gnomAD v2.1
      v4.1
      This variant is present in gnomAD v4.1 (AF= 6.1962e-07; MAF= 0.00006%, 1/1613892 alleles, homozygotes = 0) and has highest observed frequency in the European (non-Finnish) population (AF= 8.47509e-07; MAF= 0.00008%, 1/1179928 alleles, homozygotes = 0).
      v2.1
      Absent from gnomAD v2.1.
      🇨🇦 CA
      Absent from gnomAD-Canada v1.0.
      Allele frequency by ancestry
      three datasets · side by side
      gnomAD v4.1
      6.2e-05% · 1 / 1,613,892
      0 hom
      European (non-Finnish)
      1 / 1,179,928
      8.5e-05%
      + 9 not observed (Remaining individuals, Admixed American, European (Finnish), Amish, East Asian, Middle Eastern, South Asian, Ashkenazi Jewish, African/African American)
      gnomAD v2.1
      Absent · 0 / ?
      0 hom
      Not observed in any ancestry group.
      gnomAD Canada 🇨🇦
      Absent · 0 / ?
      0 hom
      Not observed in any ancestry group.
      ClinVar screenshot
      ClinVar
      This variant has been reported in ClinVar as Likely pathogenic (6 clinical laboratories) and as Pathogenic (1 clinical laboratory). (ClinVarID = 376637)
      SpliceAI screenshot
      In silico
      SpliceAI predicts no significant splice impact for this variant (max delta score = 0.04). REVEL score = 0.897. BayesDel score = 0.10537.
      Functional / OncoKB screenshot
      Functional Oncogenic
      OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Loss-of-function; curated oncogenicity label: Oncogenic.
      OncoKB ↗
      COSMIC screenshot
      COSMIC
      Cancer hotspots screenshot
      Cancer hotspots
      Somatic evidence Hotspot
      COSMIC
      This variant lies in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV52661127, n = 56 times).
      Hotspots
      This variant lies in a statistically significant hotspot.
      Literature · how each cited paper was used
      1papers cited
      Each card is an audit: what was searched, what was found, whether it names the variant, which criteria it fed, and why. 7 further PMIDs triaged but not cited — see Sources & References.
      The gain of function of p53 mutant p53S in promoting tumorigenesis by cross-talking with H-RasV12.
      Searched
      N239SAsn239Serp53SN236Sc.716A>G
      Found
      N239S (referred to as p53S) is the primary subject of this study. The mutant lost DNA binding activity to p21 and PERP promoters by EMSA, lost transactivation of p21, cyclin G1, PUMA, and Bax in response to irradiation by real-time PCR, and did not suppress tumorigenesis. Cooperating with H-RasV12, p53S promoted tumorigenesis in xenograft assays, demonstrating gain-of-function oncogenic properties. N239S is described as a non-functional mutation in yeast and mammalian assays.
      Variant
      ✓ Names this variant — characterised directly
      Applied to
      PS3 supports · met
      Why
      Provides confirmatory functional evidence that N239S is non-functional; consistent with the VCEP PS3 assignment. Data are from somatic/gain-of-function experimental context.
      The p53 N236S (p53 N239S in human, p53S) mutation has been shown to lose wild type p53 function by yeast assay. ... Functional assays in yeast and structure-function predictions indicate that p53 N239S is a non-functional mutation.
      Location Abstract; Introduction paragraphs 2-5; Results (Figures 1-4); Discussion paragraphs 1-4  ·  Context Mouse embryonic fibroblasts (p53-/- MEFs), EMSA with in vitro translated proteins, real-time PCR, xenograft in SCID mice, Western blotting, flow cytometry  ·  full text
      Sources & reference links
      9Sources
      CSpec VCEP
      ClinVar
      gnomAD v2.1
      gnomAD v4.1
      gnomAD-Canada
      SpliceAI
      OncoKB
      COSMIC
      Cancer hotspots
      Triaged references · 7 PMIDs not cited in assessment
      10366100 ↗ Dominant-negative p53 mutations in rheumatoid arthritis. CLINVAR
      10753186 ↗ High frequency in esophageal cancers of p53 alterations inactivating the regulation of genes involved in cell cycle and apoptosis. CLINVAR
      11429705 ↗ p53 mutants can often transactivate promoters containing a p21 but not Bax or PIG3 responsive elements. CLINVAR
      11896595 ↗ Tumour p53 mutations exhibit promoter selective dominance over wild type p53. CLINVAR
      12826609 ↗ Understanding the function-structure and function-mutation relationships of p53 tumor suppressor protein by high-resolution missense mutation analysis. CLINVAR
      16861262 ↗ Inactive full-length p53 mutants lacking dominant wild-type p53 inhibition highlight loss of heterozygosity as an important aspect of p53 status in human cancers. CLINVAR
      28492532 ↗ Sherloc: a comprehensive refinement of the ACMG-AMP variant classification criteria. CLINVAR