About EGFR
No gene-level summary was recorded for this case.
No variant summary was recorded for this case.
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.
Gene-level background from the recorded interpretation.
Words with a dotted underline have a short definition. Hover or tap them.No gene-level summary was recorded for this case.
The recorded framework is Not recorded. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.
The applied criteria and their strengths are shown as assessed under the stated framework.
p.His773dup is located in the EGFR tyrosine kinase domain, specifically in exon 20 within the C-helix/post-C-helix region (residues 762–823). This is a well-characterized critical functional domain essential for kinase activity and ATP/drug binding. Exon 20 insertions in this region are established oncogenic drivers in NSCLC.
NM_005228.4:c.2317_2319dupCAC is absent from all population databases: gnomAD v2.1 (exomes), gnomAD v4.1 (exomes), and gnomAD-Canada v1.0. Under generic ACMG/AMP non-VCEP rules, absence from population databases meets PM2 at moderate strength (AF < 0.1%).
NM_005228.4:c.2317_2319dupCAC causes an in-frame duplication (p.His773dup), resulting in a protein length change by insertion of one amino acid in a non-repeat region of EGFR. PM4 applies to in-frame deletions/insertions in non-repeat regions.
No benign criterion marked as applied in the recorded assessment.
gene-specific framework lacked a usable explicit final combination framework, so generic ACMG/AMP 2015 final-combination rules were applied as fallback; applied criteria: PM1 moderate, PM2 moderate, PM4 moderate; combination = 3 moderate, which maps to Likely Pathogenic.
Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.
gnomAD v4.1 allele counts were not recorded for this variant.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
Recorded SpliceAI maximum delta score: 0.000. Refer to the recorded PP3/BP4 rationale for interpretation.
1 Uncertain significance. ClinVar API review status: no assertion criteria provided.
OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Gain-of-function; curated oncogenicity label: Likely Oncogenic.
This variant has previously been reported in somatic cancers (COSMIC; COSV51781591, n = 15 times).
This variant does not lie in a statistically significant hotspot.
ACMG/AMP criteria under Not recorded, with the data and sources behind each one.
28 criteria with recorded statuses: 3 met · 12 not met · 5 not assessed · 8 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.
NM_005228.4:c.2317_2319dupCAC (p.His773dup) is an in-frame duplication in exon 20 of EGFR, located in the tyrosine kinase domain C-helix/post-C-helix region, a critical functional domain (PM1).
This variant is absent from all population databases including gnomAD v2.1, v4.1, and gnomAD-Canada (PM2).
The in-frame duplication results in a protein length change (p.His773dup) in a non-repeat region of EGFR (PM4).
ClinVar classifies this variant as Uncertain significance (Variation ID 45261, 0-star review status) based on a single clinical laboratory submission with no assertion criteria provided.
OncoKB annotates this variant as Likely Oncogenic with gain-of-function biological effect. COSMIC reports 15 somatic observations (COSV51781591), consistent with a role in tumorigenesis.
No variant-specific functional studies were identified for p.His773dup in the reviewed literature. Sister exon 20 insertion variants at His773 (His773_Val774insHis) have been characterized as conferring EGFR TKI resistance in vitro, but the exact variant has not been experimentally tested.
SpliceAI predicts no splice alteration (max delta = 0.00). REVEL and BayesDel are not applicable to this variant type.
No criteria match.
Every interpreted variant in EGFR, mapped onto the exon structure of NM_005228.4. Select a row to find it on the plot.
| Protein | Location | Classification | Link |
|---|
Absent from gnomAD v4.1.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00).
8 paper records listed. 2 cited in the classification. None of the listed paper records explicitly indicates that the variant is named.
Mutations in exon 20 could be in-frame duplication and/or insertion, such as A767_V769dupASV or H773_V774insH. They could also be point mutations. Examples of reported exon 20 mutations in literature are V765M, S768I, H773R, and T790M.
Location Table 1, Table 2; introduction (line 42-44)
Context DNA sequencing of NSCLC tumor specimens; clinical cohort (n=23 with exon 20 mutations)
His773_Val774insHis,27 have been shown to be resistant to gefitinib and erlotinib; the insertions had 50% inhibitory concentrations (IC50) to gefitinib or erlotinib, of higher than 3 μmol/L.
Location Table 1 (EGFR exon 20 insertion mutations by amino acid position); Preclinical Studies section
Context Review; functional data from Ba/F3 and NIH-3T3 surrogate assays for His773_Val774insHis
We identified one deletion mutation and four substitution mutations but no duplication/insertion mutations in exon 20.
Results: EGFR mutations section; Table 2; Discussion
Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.
The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.
Absent from gnomAD v4.1.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
This variant has been reported in ClinVar as Uncertain significance (1 clinical laboratory). (ClinVarID = 45261)
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00).
OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Gain-of-function; curated oncogenicity label: Likely Oncogenic.
This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV51781591, n = 15 times).
This variant does not lie in a statistically significant hotspot.