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Variant interpretation report

MAP2K1 c.167A>C, p.Gln56Pro

NM_002755.4:c.167A>C NP_002746.1:p.(Gln56Pro) Missense · exon 2 View identifiers
Classification
Likely pathogenic

Variant description:

The MAP2K1 NM_002755.4:c.167A>C (NP_002746.1:p.(Gln56Pro)) missense variant has previously been reported in somatic cancers (COSMIC; COSV61068787, n = 37 times), and lies in a statistically significant hotspot (cancerhotspots.org). Experimental evidence: Q56P shows increased ERK-pathway activity in variant-specific studies, but two distinct approved assay types are not established for Moderate strength. Based on available guidelines, this variant is considered to be Likely Pathogenic.

Five-step scale from benign to pathogenic. This variant is likely pathogenic. Select a step to read what it means.

Likely pathogenic.A likely pathogenic classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About MAP2K1

MAP2K1 encodes MEK1, a kinase that relays signals in the MAPK pathway to help regulate cell growth, division, differentiation, development, and survival. Abnormal MAP2K1 signaling is associated with cancer, particularly through activation of the MAPK pathway in cancers such as melanoma, colorectal cancer, and lung cancer, although activating MAP2K1 mutations are uncommon in primary tumors. MAP2K1 alterations can also contribute to resistance to some targeted cancer treatments.

LYFE Sciences is an AI system, and it can make mistakes. Criteria may be applied incorrectly, sources may be misread, and a confident-looking classification can still be wrong. Double-check every criterion and its underlying evidence before relying on any call.
01The reasoning

How it was classified

The recorded framework is ClinGen MAP2K1 VCEP v2.3. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.

Recorded applied criteria

The applied criteria and their strengths are shown as assessed under the stated framework.

Pathogenic evidence criteria: 5 Benign evidence criteria: 0
Pathogenic criteria applied · 5
PS1Strong
PS1 · strong

Met, strong: the exact p.Q56P amino acid change is previously reported and the matching ClinVar record is Pathogenic from three clinical laboratories.

PS3Supporting
PS3 · supporting

Met, Supporting: Q56P shows increased ERK-pathway activity in variant-specific studies, but two distinct approved assay types are not established for Moderate strength.

PM1Moderate
PM1 · moderate

Met, moderate: residue 56 falls within the VCEP-approved critical domain AA 43-61, one of the two explicitly permitted PM1 regions.

PM2Supporting
PM2 · supporting

Met at supporting: the variant is absent from gnomAD v2.1 and v4.1, satisfying the VCEP requirement that it be absent from gnomAD controls.

PP3Supporting
PP3 · supporting

Met: REVEL 0.841 exceeds the VCEP PP3 missense threshold of 0.7.

Benign criteria applied · 0

No benign criterion marked as applied in the recorded assessment.

Recorded classification: Likely pathogenic

Likely Pathogenic: PS1 strong plus PM1 moderate satisfy MAP2K1 VCEP Rule11, with additional supporting PS3, PM2, and PP3.

02The sources

Evidence at a glance

Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.

No screenshot for this evidence
REVEL score
0.841 recorded score

Recorded REVEL score: 0.841. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
3 reported laboratory submissions

3 Pathogenic. ClinVar API review status: criteria provided, multiple submitters, no conflicts.

Context only ClinVar ↗
Functional evidence
Statement recorded

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Gain-of-function; curated oncogenicity label: Oncogenic.

COSMIC
Cancer Hotspots
Somatic evidence
37 recorded samples

This variant has previously been reported in somatic cancers (COSMIC; COSV61068787, n = 37 times).

Cancer Hotspots

This variant lies in a statistically significant hotspot.

For specialists

Technical detail

ACMG/AMP criteria under ClinGen MAP2K1 VCEP v2.3, with the data and sources behind each one.

28 criteria with recorded statuses: 5 met · 3 not met · 10 not assessed · 10 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

No segregation, non-segregation, or de novo family evidence is documented for this variant; therefore PS2, PM6, PP1, and BS4 are not assessed under the MAP2K1 VCEP specifications.

For this phenotype/prevalence group, PP4, PP5, and BP6 are explicitly not applicable under MAP2K1 CSPEC v2.3.

PS4 cannot be assigned because the available reports do not provide the VCEP-required RASopathy point assignment or an evaluable affected-versus-control comparison; BP5 cannot be assigned because no alternate causative variant and point assignment are documented.

Population evidence supports PM2 at Supporting strength because the variant is absent from both queried all-comers gnomAD datasets.

BA1 and BS1 are not met because no gnomAD allele frequency is present, and BS2 is not assessed because the VCEP point-based healthy-individual evidence is unavailable.

Met · 5

PS1 StrongVCEPMet, strong: the exact p.Q56P amino acid change is previously reported and the matching ClinVar record is Pathogenic from three clinical laboratories. Details ▾Hide ▴
Reasoning

The queried variant produces p.Gln56Pro (p.Q56P). This same amino acid change has been explicitly reported in MAP2K1 by multiple full-text studies, including recurrent Q56P observations and activating functional results, and the exact ClinVar variation is classified Pathogenic by three clinical laboratories. The VCEP permits PS1 at strong strength for the same amino acid change as a previously established pathogenic variant, including analogous MAP2K1 positions.

VCEP rule
Same amino acid change as a previously established pathogenic variant regardless of nucleotide change. Applicable for observed analogous residue positions in _MAP2K1_ and _MAP2K2_.
Evidence considered
  • The case normalizes NM_002755.4:c.167A>C to NP_002746.1:p.(Gln56Pro), also p.(Q56P).
  • ClinVar variation 375978 lists NM_002755.4(MAP2K1):c.167A>C (p.Gln56Pro) as Pathogenic with three clinical-laboratory submissions and no conflicts.
  • PMID:25351745 explicitly reports Q56P in 6 of 26 institution-identified MEK1-mutated lung cancer cases and reports increased kinase activity, ERK phosphorylation, and anchorage-independent colony formation for Q56P.
  • PMID:22327936 explicitly describes MAP2K1(Q56P) and reports transforming activity, increased ERK1/2 phosphorylation, and approximately 10-fold increased enzymatic activity.
  • PMID:18632602 explicitly reports Q56P and cites approximately 170-fold greater MEK1Q56P activity than wild type in phosphorylation of recombinant ERK.
Sources
PS3 SupportingVCEPMet, Supporting: Q56P shows increased ERK-pathway activity in variant-specific studies, but two distinct approved assay types are not established for Moderate strength. Details ▾Hide ▴
Reasoning

The MAP2K1 VCEP permits PS3 Supporting for one approved assay and PS3 Moderate only for two or more different approved assays. The VCEP approved-functional-studies file was searched for c.167A>C, p.Gln56Pro, and p.Q56P; it contains no variant-specific row or pre-assigned code. Variant-specific functional evidence is present in PMID:25351745, where Q56P increased MEK1-associated kinase activity and ERK phosphorylation and promoted anchorage-independent colony formation, and in PMID:22327936, where MAP2K1(Q56P) markedly increased ERK1/2 phosphorylation and transforming activity. The damaging ERK-pathway readout corresponds to an approved ERK Activation Assay, but the available evidence does not establish two distinct approved assay types for this variant; therefore PS3 is met at Supporting rather than Moderate strength. PMID:18632602 also reports prior transformation competence and approximately 170-fold increased in-vitro ERK phosphorylation activity for MEK1Q56P, but does not provide a second VCEP-approved assay type.

VCEP rule
Two or more different approved assays ... One approved assay.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 PS3 rule: "Two or more different approved assays." for Moderate and "One approved assay." for Supporting.
  • SVI-RASopathy-VCEP-V2-Approved-Functional-Studies.xlsx, READ ME and MEK/ERK Activation Assay tables: pathway-specific MEK and ERK phosphorylation assays are approved; two or more unique assay types can upgrade PS3 to Moderate. The file has no row for c.167A>C, p.Gln56Pro, or p.Q56P.
  • PMID:25351745, Results, Functional characterization of MEK1 mutants: Q56P was included among tested MAP2K1 variants; mutant studies showed increased kinase activity and ERK-pathway phosphorylation, and Q56P supported anchorage-independent colony formation inhibited by 1 µM selumetinib.
  • PMID:22327936, Results, Transforming ability of MAP2K1(Q56P): Q56P markedly increased ERK1/2 phosphorylation and showed transforming activity in fibroblast and tumorigenicity assays.
  • PMID:18632602, Introduction/Discussion and Results: MEK1Q56P was reported as transformation-competent and approximately 170-fold more active than wild type at phosphorylating recombinant ERK in vitro; the paper does not establish a second distinct approved VCEP assay type.
Still missing
  • SVI-RASopathy-VCEP-V2-Approved-Functional-Studies.xlsx was searched for c.167A>C, p.Gln56Pro, and p.Q56P; no variant-specific row or pre-assigned code was found.
  • Variant-specific evidence demonstrating a second distinct approved assay type, required by the VCEP for PS3 Moderate, is not available in the reviewed sources.
Sources
PM1 ModerateVCEPMet, moderate: residue 56 falls within the VCEP-approved critical domain AA 43-61, one of the two explicitly permitted PM1 regions. Details ▾Hide ▴
Reasoning

The variant is at residue 56, which lies within the VCEP-defined critical functional domain AA 43-61. The VCEP PM1 rule limits application to the supplementary-table domains AA 43-61 and AA 124-134 and excludes specific-residue evidence as a PM5 route; residue 56 satisfies the domain route. The governing MAP2K-Alignment.xlsx file was searched for c.167A>C, p.Gln56Pro, and p.Q56P, with no matching variant entry; its flattened text contains no residue-56 assignment that overrides the CSPEC domain definition.

VCEP rule
Applicable only to critical and well-established functional domains available in the supplementary table (AA 43-61, AA 124-134). Not applicable to specific amino acid residues (see PM5).
Evidence considered
  • The VCEP CSPEC specifies PM1 only for critical and well-established functional domains AA 43-61 and AA 124-134; residue 56 is in AA 43-61.
  • MAP2K-Alignment.xlsx, sheet 'MAP2K Alignment', was searched for c.167A>C, p.Gln56Pro, and p.Q56P; no matching variant entry was found.
  • PMID:25351745 places Q56 in the C-terminal alpha-helix interface and reports that mutations in this region are likely to deregulate kinase function; this paper was consulted as supporting functional-domain context.
Still missing
  • No entry for c.167A>C, p.Gln56Pro, or p.Q56P was found in MAP2K-Alignment.xlsx.txt.
Sources
PM2 SupportingVCEPMet at supporting: the variant is absent from gnomAD v2.1 and v4.1, satisfying the VCEP requirement that it be absent from gnomAD controls. Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP permits PM2 at supporting strength when the variant is absent from controls in gnomAD. The variant is reported absent from gnomAD v2.1 and gnomAD v4.1, so PM2 Supporting is met. The VCEP rule does not specify a non-cancer or exome-only subset, so the available all-comers gnomAD entries are used.

VCEP rule
The variant must be absent from controls (gnomAD).
Evidence considered
  • ClinGen RASopathy MAP2K1 VCEP v2.3 CSPEC PM2 rule: the variant must be absent from controls (gnomAD), with PM2 assigned at supporting strength.
  • gnomAD v2.1: variant absent from the queried all-comers dataset.
  • gnomAD v4.1: variant absent from the queried all-comers dataset.
Sources
PP3 SupportingVCEPMet: REVEL 0.841 exceeds the VCEP PP3 missense threshold of 0.7. Details ▾Hide ▴
Reasoning

The VCEP PP3 rule covers missense variants through REVEL and assigns PP3 at REVEL >= 0.7; its separate splicing path requires a predicted outcome matching the disease mechanism. This variant is a missense variant, p.(Gln56Pro), and the governing missense predictor is REVEL. The REVEL score is 0.841, which meets the VCEP cutoff. SpliceAI is not used to add a second PP3 observation, so the prediction is not double-counted across computational criteria.

VCEP rule
For missense variants: REVEL ≥ 0.7. For splicing impact, predicted outcome must match disease mechanism.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC PP3 rule: for missense variants, REVEL >= 0.7; for splicing impact, predicted outcome must match disease mechanism.
  • Local REVEL predictor lookup: NM_002755.4:c.167A>C, MAP2K1 p.(Gln56Pro), REVEL score 0.841; 0.841 >= 0.7, so PP3 Supporting is met.
Sources

Not met · 3 · evaluated, threshold not reached

BA1 VCEPNot met: the variant is absent from both gnomAD v2.1 and v4.1, rather than reaching the VCEP's >=0.05% filtering allele-frequency threshold. Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP requires a gnomAD filtering allele frequency of at least 0.05% for BA1. The variant is absent from gnomAD v2.1 and gnomAD v4.1, so no qualifying allele frequency is present and BA1 is not met.

VCEP rule
GnomAD filtering allele frequency ≥0.05%.
Evidence considered
  • ClinGen RASopathy MAP2K1 VCEP v2.3 CSPEC BA1 rule: GnomAD filtering allele frequency >=0.05%.
  • gnomAD v2.1: variant absent; no allele-frequency record was returned.
  • gnomAD v4.1: variant absent; no allele-frequency record was returned.
Sources
BS1 VCEPNot met: the variant is absent from both gnomAD v2.1 and v4.1, rather than reaching the VCEP's >=0.025% filtering allele-frequency threshold. Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP requires a gnomAD filtering allele frequency of at least 0.025% for BS1. The variant is absent from gnomAD v2.1 and gnomAD v4.1, so no qualifying allele frequency is present and BS1 is not met.

VCEP rule
GnomAD filtering allele frequency ≥0.025%.
Evidence considered
  • ClinGen RASopathy MAP2K1 VCEP v2.3 CSPEC BS1 rule: GnomAD filtering allele frequency >=0.025%.
  • gnomAD v2.1: variant absent; no allele-frequency record was returned.
  • gnomAD v4.1: variant absent; no allele-frequency record was returned.
Sources
BP4 VCEPNot met: REVEL 0.841 is above the VCEP BP4 missense threshold of 0.3. Details ▾Hide ▴
Reasoning

The VCEP BP4 rule applies to missense variants and requires REVEL <= 0.3. This variant is missense, p.(Gln56Pro), so BP4 is applicable. The available REVEL score is 0.841, which is above the VCEP benign-supporting cutoff and therefore does not satisfy BP4. The SpliceAI no-impact result is not used for BP4 because the VCEP names REVEL for the missense situation, and the same computational prediction is not double-counted across PP3 and BP4.

VCEP rule
For missense variants: REVEL ≤0.3.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BP4 rule: for missense variants, REVEL <= 0.3.
  • Local REVEL predictor lookup: NM_002755.4:c.167A>C, MAP2K1 p.(Gln56Pro), REVEL score 0.841; 0.841 > 0.3, so BP4 is not met.
Sources

Not assessed · 10 · no assessment recorded

PS2 VCEPNot assessed: no documented proband-parent testing or confirmed de novo result is available to assign the VCEP's 1-, 2-, or 4-point PS2 thresholds. Details ▾Hide ▴
Reasoning

The VCEP assigns PS2 by de novo evidence points: 4 points for Very Strong, 2 points for Strong, and 1 point for Moderate. The available case evidence contains no documented affected proband, parental testing results, confirmed de novo status, maternity/paternity confirmation, or phenotype-consistency assessment, so no PS2 points can be assigned.

VCEP rule
4 Points. ... 2 Points. ... 1 Point.
Evidence considered
  • No proband-level de novo observation, parental testing result, maternity/paternity confirmation, or phenotype-consistency evidence is documented in the available case evidence.
Still missing
  • Documented proband phenotype and diagnosis consistent with the MAP2K1-related disorder
  • Testing results for both biological parents
  • Confirmation that the variant is absent in both parents and that maternity/paternity are confirmed
  • Evidence needed to assign the VCEP's PS2 de novo points
Sources
PS4 VCEPNot assessed: available reports describe somatic cancer or ECD observations, but provide no VCEP RASopathy point assignment or case-control counts for PS4. Details ▾Hide ▴
Reasoning

The VCEP makes PS4 applicable and requires point-based scoring for autosomal-dominant RASopathy cases, with full or reduced points depending on phenotype information. The available literature reports Q56P in somatic lung and gastric cancer cell lines and one ECD patient, not an evaluable RASopathy case-control cohort or a VCEP phenotypic point assignment. Therefore the required PS4 point total cannot be established. No odds ratio or 95% confidence interval can be computed from the available reports because matched affected and unaffected/population control counts are not reported.

VCEP rule
Strength adjustment using point-based scoring for autosomal dominant cases with phenotypic specifications: full points awarded with RASopathy phenotypes, reduced points applicable to cases with minimal phenotypic information (i.e. prenatal cases, cases with a clinical order of a RASopathy panel without clinical information, and cases with limited clinical information in other global tests (such as WES)). ... ≥5 points. ... ≥3 points. ... ≥1 points.
Evidence considered
  • ClinGen RASopathy MAP2K1 CSPEC v2.3: PS4 is applicable, uses point-based scoring for autosomal-dominant cases with phenotypic specifications, and assigns Strong/Moderate/Supporting at >=5, >=3, and >=1 points respectively.
  • Marks et al. 2008 (PMID:18632602): screening of 85 NSCLC cell lines found Q56P in NCI-H1437; the report concerns a somatic cancer cell-line cohort and does not provide a RASopathy affected-control comparison or VCEP point score.
  • Choi et al. 2012 (PMID:22327936): Q56P was identified in the OCUM-1 gastric cancer cell line and shown to be activating; this is a somatic tumor-cell observation, not a RASopathy case-control comparison.
  • Arcila et al. 2015 (PMID:25351745): Q56P occurred in 6/26 institution-identified MEK1-mutated lung adenocarcinoma cases within a 5330-patient screening cohort; no unaffected/population control count or RASopathy point assignment is reported.
  • Hyman et al. 2015 (PMID:26566875): one ECD patient had MAP2K1 Q56P-mutant disease and responded to cobimetinib; this does not establish VCEP PS4 points or a case-control comparison.
Still missing
  • VCEP point assignments for affected autosomal-dominant RASopathy cases are unavailable.
  • No matched affected-versus-unaffected/population control counts are reported, so an OR and 95% CI cannot be calculated.
Sources
PM5 VCEPNot assessed: no different likely pathogenic substitution at codon 56 was identified, but the comparator search ended with an HTTP 429 retrieval error. Details ▾Hide ▴
Reasoning

The VCEP requires one different likely pathogenic residue change at the same codon for PM5 at moderate strength. The reviewed paper extracts and full-text literature report Q56P but do not establish a different missense substitution at codon 56. The dedicated same-residue comparator collection found no useful candidate and recorded an HTTP 429 retrieval error, so the available evidence cannot establish that the complete comparator search was successful; PM5 is therefore not assessed rather than called not met.

VCEP rule
1 [likely] pathogenic residue change at the same codon.
Evidence considered
  • The VCEP PM5 moderate rule requires 1 different likely pathogenic residue change at the same codon.
  • pm5_candidates.json reports zero same-residue candidates and an HTTP Error 429: Too Many Requests during candidate harvesting.
  • PMID:25351745, PMID:22327936, and PMID:18632602 report Q56P but no different substitution at residue 56 in the extracted or searched full text.
Still missing
  • A complete reliable search for different likely pathogenic MAP2K1 missense substitutions at codon 56 is still required; the comparator collection failed with HTTP 429.
Sources
PM6 VCEPNot assessed: no apparently de novo occurrence with documented parental testing is available to assign the VCEP's 0.5-, 1-, or 2-point PM6 thresholds. Details ▾Hide ▴
Reasoning

The VCEP assigns PM6 by de novo evidence points: 2 points for Strong, 1 point for Moderate, and 0.5 points for Supporting. The available case evidence does not document an apparently de novo occurrence without the required parental and identity information, so PM6 cannot be scored.

VCEP rule
2 Points. ... 1 Point. ... 0.5 Points.
Evidence considered
  • No apparently de novo proband observation or parental testing result is documented in the available case evidence.
Still missing
  • A documented apparently de novo proband observation
  • Parental testing and biological-parent identity information
  • Evidence sufficient to assign the VCEP's PM6 de novo points
Sources
PP1 VCEPNot assessed: zero informative meioses are documented, below the VCEP's minimum threshold of at least 3 for PP1 Supporting. Details ▾Hide ▴
Reasoning

The VCEP assigns PP1 as Supporting for at least 3 informative meioses, Moderate for at least 5 informative meioses, and Strong for at least 7 informative meioses. No informative meioses, affected relatives carrying the variant, or family segregation data are documented, so PP1 cannot be assessed.

VCEP rule
≥7 informative meioses. ... ≥5 informative meioses. ... ≥3 informative meioses.
Evidence considered
  • No family segregation observations or informative meioses are documented in the available case evidence.
Still missing
  • Family genotypes and phenotypes for informative relatives
  • A count of informative meioses
  • Segregation data sufficient to evaluate the thresholds of at least 3, 5, or 7 informative meioses
Sources
PP2 VCEPNot assessed: the VCEP requires a gnomAD missense z score >3.09, but no missense z score is available for MAP2K1. Details ▾Hide ▴
Reasoning

The variant is missense, so the VCEP PP2 rule is applicable in principle, but the required gnomAD missense z score is not present in the available case evidence. No substitute population threshold, predictor, or generic PP2 rule is permitted under the governing instructions.

VCEP rule
Missense z score is >3.09 in gnomAD.
Evidence considered
  • The case consequence is missense, but the available gnomAD records contain only variant-level absence and no MAP2K1 missense z score.
Still missing
  • gnomAD MAP2K1 missense z score is unavailable.
Sources
BS2 VCEPNot assessed: no healthy homozygote or heterozygote observation is available to assign the VCEP's required -4-point or -1-point BS2 score. Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP evaluates BS2 using point-based scoring from phenotypic specifications, with -4 points for strong and -1 point for supporting evidence. The available evidence contains no healthy homozygote or heterozygote observation, no unaffected parent or sibling observation, and no point assignment; therefore BS2 cannot be assessed.

VCEP rule
Strength adjustment using point-based scoring based on phenotypic specifications. Phenotypic specifications: based on healthy homozygote or heterozygote individuals, reduced points for apparently unaffected heterozygous individuals, applicable to parent or sibling samples during clinical family evaluations. ... -4 Points. ... -1 Point.
Evidence considered
  • ClinGen RASopathy MAP2K1 VCEP v2.3 CSPEC BS2 instructions: strength adjustment uses point-based scoring based on phenotypic specifications, including healthy homozygote or heterozygote individuals and reduced points for apparently unaffected heterozygous individuals.
  • ClinGen RASopathy MAP2K1 VCEP v2.3 CSPEC BS2 strength rules: -4 points corresponds to strong evidence and -1 point corresponds to supporting evidence.
  • No qualifying healthy individual, unaffected parent or sibling, homozygote count, heterozygote count, or BS2 point assignment is present in the available case evidence.
Still missing
  • A qualifying healthy homozygote or heterozygote observation and the corresponding VCEP phenotypic-specification point assignment are unavailable.
Sources
BS4 VCEPNot assessed: no informative non-segregating meiosis is documented, whereas the VCEP requires one informative meiosis for BS4. Details ▾Hide ▴
Reasoning

The VCEP requires only one informative meiosis for BS4. The available case evidence documents no informative meiosis or tested unaffected relative who does not carry the variant, so non-segregation cannot be evaluated.

VCEP rule
Requires only one informative meiosis.
Evidence considered
  • No unaffected-relative genotype, phenotype, or non-segregation observation is documented in the available case evidence.
Still missing
  • An unaffected informative relative with documented phenotype and genotype
  • Family data establishing at least one informative non-segregating meiosis
Sources
BP2 VCEPNot assessed: no affected-proband evidence documents a second pathogenic MAP2K1 variant, cis/trans phase, and phenotype severity required for ≥ (-1) BP2 point. Details ▾Hide ▴
Reasoning

The VCEP permits BP2 when an alternative molecular cause of a RASopathy is present in the same gene, with phenotype severity consistent with the RASopathy, and assigns supporting strength at ≥ (-1) Point. The available case evidence does not document an affected proband carrying another pathogenic MAP2K1 variant, the phase of any second variant as cis or trans, or the phenotype-severity information needed to award BP2 points. Somatic reports and functional studies for p.Gln56Pro do not establish an allelic relationship in an affected RASopathy proband.

VCEP rule
Points are awarded for an alternative molecular cause of a RASopathy in the same gene (and/or in conjunction with BP5) and the phenotype is consistent with expected severity of the RASopathy. ... ≥ (-1) Point.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BP2 entry: points require an alternative molecular cause of a RASopathy in the same gene, with phenotype consistent with expected severity; supporting strength requires ≥ (-1) Point.
  • The case evidence documents the queried MAP2K1 p.Gln56Pro variant and somatic/functional reports, but does not document a second pathogenic MAP2K1 variant in an affected RASopathy proband or its cis/trans phase.
  • No available case evidence provides the phenotype-severity assessment needed for the VCEP BP2 point-based rule.
Still missing
  • Affected-proband documentation for an alternative pathogenic MAP2K1 molecular cause.
  • Parent/offspring or other direct testing establishing cis or trans phase between p.Gln56Pro and the alternative MAP2K1 variant.
  • Clinical phenotype and severity information sufficient to determine consistency with the expected RASopathy severity.
Sources
BP5 VCEPNot assessed: no documented alternate causative variant or VCEP BP5 point assignment is available for this case. Details ▾Hide ▴
Reasoning

BP5 is applicable only when an alternative molecular cause of a RASopathy in a different gene, or a phenotype inconsistent with RASopathy fully explained by another causative variant, is documented. The available case evidence does not provide a documented alternate causative variant, its gene, or a VCEP BP5 point assignment. Accordingly, the BP5 point total and strength cannot be evaluated.

VCEP rule
Points are awarded for an alternative molecular cause of a RASopathy in a different gene (and/or in conjunction with BP2) and the phenotype is consistent with expected severity of the RASopathy. Points are also awarded for phenotypes inconsistent with a RASopathy and fully explained by a different causative variant (e.g. WES testing). ... ≥ (-4) Points. ... ≥ (-2) Points. ... ≥ (-1) Point.
Evidence considered
  • MAP2K1 CSPEC v2.3 BP5: points require an alternative molecular cause of RASopathy in a different gene, or a phenotype inconsistent with RASopathy fully explained by a different causative variant; strength thresholds are >=(-4), >=(-2), and >=(-1) points for Strong, Moderate, and Supporting.
  • The case evidence identifies MAP2K1 Q56P and reports somatic cancer/ECD observations, but does not document a different causative gene/variant or a VCEP-assigned BP5 point value.
Still missing
  • A documented alternate molecular cause, including gene and variant, is needed.
  • The VCEP BP5 point assignment is unavailable.
Sources
Not applicable · 10· recorded as not applicable Show reasons ▾Hide reasons ▴
PVS1 VCEPNot applicable: the VCEP marks PVS1 as not applicable, and c.167A>C is a missense variant producing p.(Gln56Pro), not a loss-of-function allele. Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP specification marks PVS1 as Not Applicable. This variant is a missense substitution, NM_002755.4:c.167A>C (NP_002746.1:p.(Gln56Pro)) in exon 2, not a loss-of-function consequence; therefore PVS1 is not applied and no strength tier is assigned.

VCEP rule
Not Applicable
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 specification v2.3: PVS1 applicability is explicitly listed as Not Applicable.
  • Variant-level consequence assessment: NM_002755.4:c.167A>C; missense; exon 2; NP_002746.1:p.(Gln56Pro).
Sources
cspec ↗pvs1_variant_assessment
PM3 VCEPNot applicable: the MAP2K1 RASopathy VCEP explicitly designates PM3 as not applicable. Details ▾Hide ▴
Reasoning

The MAP2K1 RASopathy VCEP explicitly marks PM3 as not applicable. Therefore, the recessive-disorder trans-phase criterion is not evaluated for this autosomal-dominant RASopathy framework, regardless of the available variant observations.

VCEP rule
Not applicable.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC entry for PM3: applicability is explicitly listed as Not applicable.
Sources
PM4 N/ANot applicable: c.167A>C is a missense substitution causing p.(Gln56Pro), with no in-frame length change or stop-loss consequence for PM4. Details ▾Hide ▴
Reasoning

The VCEP PM4 rule is limited to protein-length-change application in a gene with no known repetitive areas. The observed variant is a missense substitution, p.(Gln56Pro), with no protein-length change, so the PM4 variant-type requirement is not met and PM4 is not applicable.

VCEP rule
No known repetitive areas in gene. Use as described.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 specification v2.3: PM4 is stated as "No known repetitive areas in gene. Use as described."
  • Variant-level consequence assessment: the variant is missense, NM_002755.4:c.167A>C, encoding NP_002746.1:p.(Gln56Pro), with no protein-length change.
Sources
cspec ↗pvs1_variant_assessment
PP4 VCEPNot applicable: the MAP2K1 VCEP explicitly excludes PP4 and directs phenotype-specific evidence to PS4. Details ▾Hide ▴
Reasoning

The MAP2K1 VCEP explicitly marks PP4 not applicable and directs phenotype-specific assessment to PS4.

VCEP rule
Not applicable, see PS4.
Evidence considered
  • MAP2K1 CSPEC v2.3 PP4 entry: applicability is Not applicable and the instruction is 'Not applicable, see PS4.'
Sources
PP5 VCEPNot applicable: the MAP2K1 VCEP explicitly prohibits use of PP5. Details ▾Hide ▴
Reasoning

The MAP2K1 VCEP explicitly states that PP5 is not for use as recommended by the ClinGen Sequence Variant Interpretation VCEP Review Committee.

VCEP rule
This criterion is not for use as recommended by the ClinGen Sequence Variant Interpretation VCEP Review Committee.
Evidence considered
  • MAP2K1 CSPEC v2.3 PP5 entry: applicability is Not Applicable for this VCEP and the criterion is not for use.
Sources
BS3 VCEPNot applicable: the MAP2K1 VCEP marks BS3 as not applicable, and the reviewed studies report activating rather than normal functional results. Details ▾Hide ▴
Reasoning

The MAP2K1 VCEP explicitly marks BS3 as not applicable. The reviewed variant-specific studies report damaging or activating effects rather than a validated normal-function result, but that evidence does not change the VCEP's applicability designation.

VCEP rule
Not applicable
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BS3 entry: applicability is "Not applicable".
  • SVI-RASopathy-VCEP-V2-Approved-Functional-Studies.xlsx, READ ME and assay tables: the listed MAP2K1 pathway assays are proposed as PS3_Supporting; BS3_NA, and no variant-specific normal-function result is provided for Q56P.
Sources
BP1 N/ANot applicable: p.Gln56Pro is missense, whereas the VCEP BP1 rule is restricted to specified truncating variant types. Details ▾Hide ▴
Reasoning

The variant is a missense substitution, p.Gln56Pro. The VCEP BP1 rule applies to truncating variants, specifically nonsense, frameshift, canonical splice-site, initiation-codon, entire-gene, or multi-exon deletions in the stated gene context; none describes this missense variant.

VCEP rule
This rule has contraindications for use with RASopathies. Given the disease mechanism is gain-of-function for RASopathies, BP1 should be used for any truncating variant (nonsense, frameshift, affects canonical splice sites, initiation codon, entire gene or multi exon deletion) in genes without established LOF correlation to disease. See the supplemental material regarding dosage sensitivity information for each individual gene and potential association to disorders associated with LOF variants.
Evidence considered
  • The case consequence is missense and the normalized protein change is NP_002746.1:p.(Gln56Pro).
Sources
BP3 VCEPNot applicable: the VCEP marks BP3 as not applicable, and c.167A>C is a missense variant encoding p.(Gln56Pro). Details ▾Hide ▴
Reasoning

The governing MAP2K1 VCEP specification marks BP3 as Not Applicable. The variant is a missense substitution rather than an applicable benign in-frame change in a repetitive region, so BP3 is not applied.

VCEP rule
Not Applicable
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 specification v2.3: BP3 applicability is explicitly listed as Not Applicable.
  • Variant-level consequence assessment: NM_002755.4:c.167A>C is a missense variant encoding NP_002746.1:p.(Gln56Pro).
Sources
cspec ↗pvs1_variant_assessment
BP6 VCEPNot applicable: the MAP2K1 VCEP explicitly prohibits use of BP6. Details ▾Hide ▴
Reasoning

The MAP2K1 VCEP explicitly marks BP6 not applicable and states that the criterion is not for use.

VCEP rule
This criterion is not for use as recommended by the ClinGen Sequence Variant Interpretation VCEP Review Committee.
Evidence considered
  • MAP2K1 CSPEC v2.3 BP6 entry: applicability is Not Applicable for this VCEP and the criterion is not for use.
Sources
BP7 N/ANot applicable: c.167A>C is a coding missense variant, not a synonymous, intronic, or non-coding variant covered by BP7. Details ▾Hide ▴
Reasoning

The VCEP BP7 rule is limited to synonymous variants and additionally covers intronic positions other than canonical splice sites or non-coding variants. NM_002755.4:c.167A>C is a coding missense variant producing p.(Gln56Pro), so it is outside BP7 scope. BP7 is therefore not_applicable without evaluating a predictor score.

VCEP rule
A synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence nor the creation of a new splice site AND the nucleotide is not highly conserved. This rule is also applicable for intronic positions (except canonical splice sites) or non-coding variants and should be used in conjunction with BP4.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BP7 rule: synonymous variants, selected intronic positions, and non-coding variants are in scope; this variant is missense p.(Gln56Pro).
Sources

Identifiers

Gene
MAP2K1
Transcript
NM_002755.4
Coding (HGVS c.)
NM_002755.4:c.167A>C
Protein (HGVS p.)
NP_002746.1:p.(Gln56Pro)
GRCh38
chr15:66435113 A>C
GRCh37
chr15:66727451 A>C
Location and type
Exon 2 · missense
ClinVar
375978
COSMIC
COSV61068787

Gene diagram

Every interpreted variant in MAP2K1, mapped onto the exon structure of NM_002755.4. Select a row to find it on the plot.

MAP2K1NM_002755.4
Fetching transcript structure from UCSC…
gnomAD v4.1 Allele count data not recorded
gnomAD v2.1 Allele count data not recorded
gnomAD-Canada v1.0 Allele count data not recorded

Statements

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat -150 bp
0.002
SpliceAI acceptor gainat +8 bp
0.003
SpliceAI donor lossat +47 bp
0.000
SpliceAI donor gainat +10 bp
0.001
Pangolin splice lossmagnitude shown
-0.009
Pangolin splice gain
0.006

Other predictors

REVEL
0.841
BayesDel
0.494

How the predictions were used

PP3 SupportingVCEPMet: REVEL 0.841 exceeds the VCEP PP3 missense threshold of 0.7. Details ▾Hide ▴
Reasoning

The VCEP PP3 rule covers missense variants through REVEL and assigns PP3 at REVEL >= 0.7; its separate splicing path requires a predicted outcome matching the disease mechanism. This variant is a missense variant, p.(Gln56Pro), and the governing missense predictor is REVEL. The REVEL score is 0.841, which meets the VCEP cutoff. SpliceAI is not used to add a second PP3 observation, so the prediction is not double-counted across computational criteria.

VCEP rule
For missense variants: REVEL ≥ 0.7. For splicing impact, predicted outcome must match disease mechanism.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC PP3 rule: for missense variants, REVEL >= 0.7; for splicing impact, predicted outcome must match disease mechanism.
  • Local REVEL predictor lookup: NM_002755.4:c.167A>C, MAP2K1 p.(Gln56Pro), REVEL score 0.841; 0.841 >= 0.7, so PP3 Supporting is met.
Sources
BP4 VCEPNot met: REVEL 0.841 is above the VCEP BP4 missense threshold of 0.3. Details ▾Hide ▴
Reasoning

The VCEP BP4 rule applies to missense variants and requires REVEL <= 0.3. This variant is missense, p.(Gln56Pro), so BP4 is applicable. The available REVEL score is 0.841, which is above the VCEP benign-supporting cutoff and therefore does not satisfy BP4. The SpliceAI no-impact result is not used for BP4 because the VCEP names REVEL for the missense situation, and the same computational prediction is not double-counted across PP3 and BP4.

VCEP rule
For missense variants: REVEL ≤0.3.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BP4 rule: for missense variants, REVEL <= 0.3.
  • Local REVEL predictor lookup: NM_002755.4:c.167A>C, MAP2K1 p.(Gln56Pro), REVEL score 0.841; 0.841 > 0.3, so BP4 is not met.
Sources
BP7 N/ANot applicable: c.167A>C is a coding missense variant, not a synonymous, intronic, or non-coding variant covered by BP7. Details ▾Hide ▴
Reasoning

The VCEP BP7 rule is limited to synonymous variants and additionally covers intronic positions other than canonical splice sites or non-coding variants. NM_002755.4:c.167A>C is a coding missense variant producing p.(Gln56Pro), so it is outside BP7 scope. BP7 is therefore not_applicable without evaluating a predictor score.

VCEP rule
A synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence nor the creation of a new splice site AND the nucleotide is not highly conserved. This rule is also applicable for intronic positions (except canonical splice sites) or non-coding variants and should be used in conjunction with BP4.
Evidence considered
  • ClinGen RASopathy Expert Panel MAP2K1 Version 2.3 CSPEC BP7 rule: synonymous variants, selected intronic positions, and non-coding variants are in scope; this variant is missense p.(Gln56Pro).
Sources

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.841. BayesDel score = 0.49396.

7 paper records listed. 3 cited in the classification.

Cited in the classification

  • Novel MEK1 mutation identified by mutational analysis of epidermal growth factor receptor signaling pathway genes in lung adenocarcinoma.
    Marks JL et al. · 2008 Jul 15
    This paper explicitly mentions MEK1Q56P, reports Q56P in the NCI-H1437 NSCLC cell line, and summarizes prior transformation-competent and biochemical activity evidence for the variant.
    → PS1 · strong → PS3 · supporting Names this variant
    PMID 18632602 ↗
    Source detail
    Whereas no lines carried the K57N mutation, we did find that NCI-H1437 cells harbor a mutation encoding a Q56P MEK1 variant (data not shown).

    Location Introduction, paragraph 3; Results, final paragraph; Discussion, paragraph 3

    Context Screening of 85 NSCLC cell lines; NCI-H1437 characterization; prior rat-fibroblast transformation study and in vitro MEK1Q56P-GST assay measuring phosphorylation of recombinant ERK.

  • Oncogenic MAP2K1 mutations in human epithelial tumors.
    Choi YL et al. · 2012 May
    This paper explicitly describes MAP2K1(Q56P), reports its occurrence in the OCUM-1 gastric cancer cell line, and reports transforming activity, increased ERK1/2 phosphorylation, and increased MAP2K1 enzymatic activity.
    → PS1 · strong → PS3 · supporting Names this variant
    PMID 22327936 ↗
    Source detail
    Sequencing of this position in OCUM-1 genomic DNA confirmed the presence of this substitution, which results in replacement of a glutamine at amino acid position 56 with proline.

    Location Results, “Identification of MAP2K1(Q56P) in OCUM-1 cells”; “Transforming ability of MAP2K1(Q56P)”

    Context OCUM-1 scirrhous-type gastric cancer cell line; retroviral focus-formation assay in mouse 3T3 fibroblasts; tumorigenicity assay in nude mice; MAP2K1 inhibitor AZD6244 treatment; ERK1/2 phosphorylation assay in HEK293 cells.

  • MAP2K1 (MEK1) Mutations Define a Distinct Subset of Lung Adenocarcinoma Associated with Smoking.
    Arcila ME et al. · 2015 Apr 15
    This paper explicitly mentions MAP2K1 p.Q56P as a recurrent MEK1 mutation, reports Q56P in 6 of 26 institution-identified MEK1-mutated lung cancer cases, and reports increased kinase activity, ERK phosphorylation, and anchorage-independent colony formation for Q56P.
    → PS1 · strong → PS3 · supporting → PM1 · moderate Names this variant
    PMID 25351745 ↗
    Source detail
    Specific MEK1 mutations interrogated in the extended panels included Q56P, K57N and D67N. ... Amongst the 26 cases of MEK1 mutated lung cancer identified at the two institutions, K57N was the most common mutation detected, encompassing 77% (20/26) of all variants while all remaining cases harbored the Q56P (6/26). ... Western blot analysis demonstrated increased kinase activity in all mutants, except for the D67N. ... Anchorage independent growth was also assessed for mutated cell lines harboring F53L, Q56P, K57N and D67N mutations. Colony formation after 4 week culture in soft agar showed colonies of greater than 150 microns in the 4 mutant cell lines tested but not in the control or wild-type MEK1 cells. Treatment with 1 μM Selumetinib inhibited colony formation in all the mutated cell lines.

    Location Materials and Methods, Tissue procurement and mutational profiling; Results, Spectrum of MEK1 mutations; Results, Functional characterization of MEK1 mutants

    Context Lung adenocarcinoma mutation-screening cohort of 5330 patients, including 26 institution-identified MEK1-mutated cases; MAP2K1 mutant expression in 293H cells with immunoblotting for ERK/p90RSK phosphorylation; NIH-3T3 soft-agar colony-formation assay with selumetinib treatment.

Other recorded publications

  • MEK1 mutations confer resistance to MEK and B-RAF inhibition.
    No paper-specific finding is recorded.
    PMID 19915144 ↗
  • Diverse and Targetable Kinase Alterations Drive Histiocytic Neoplasms.
    The paper reports one ECD patient with MAP2K1 Q56P-mutant disease and response to cobimetinib; it does not provide a RASopathy case-control comparison, unaffected controls, or VCEP PS4 points.
    Names this variant
    PMID 26566875 ↗
    Quoted passage
    Similarly, treatment of a second ECD patient with MAP2K1Q56P-mutant disease refractory to 4 lines of prior therapy led to resolution of PET-avid disease in renal (SUV 8.4), aortic (SUV 3.9), and maxillary sinus (SUV 9.5) infiltrations to background SUV within a single month of administration of the MEK inhibitor cobimetinib (Fig. 4C).

    Results, section 'Therapeutic Targeting of MAP2K1- and ARAF-mutant Refractory Histiocytoses'; Discussion

  • American College of Medical Genetics and Genomics technical standards and guidel
    No paper-specific finding is recorded.
    PMID 23619274 ↗
  • Guideline Recommendations for Testing of ALK Gene Rearrangement in Lung Cancer: A Proposal of the Korean Cardiopulmonary Pathology Study Group.
    Kim H et al. · 2014
    No paper-specific finding is recorded.
    PMID 24627688 ↗

Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.

All source links

Statements for reports

The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar as Pathogenic (3 clinical laboratories). (ClinVarID = 375978)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.841. BayesDel score = 0.49396.

Functional

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Gain-of-function; curated oncogenicity label: Oncogenic.

Somatic

This variant lies in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV61068787, n = 37 times).

Cancer Hotspots

This variant lies in a statistically significant hotspot.