0%
complete
Final classification
VUS
BS1
POLE
c.4744C>T
p.Pro1582Ser
missense · exon 37

POLE encodes the catalytic subunit of DNA polymerase epsilon, the enzyme that replicates the leading strand of DNA during cell division and participates in DNA repair. It contains a proofreading domain that corrects replication errors, keeping the accumulation of mutations in check. Germline mutations in POLE cause polyposis and predispose to colorectal cancer, and are also linked to a rare syndrome of facial dysmorphism, immunodeficiency, livedo, and short stature. Somatic mutations, particularly in the proofreading domain, occur in colorectal and endometrial cancers, where they drive an ultra-mutated tumor phenotype and are associated with better responses to immune checkpoint inhibitors.

This variant

POLE-associated disease is driven mainly by missense changes in the exonuclease proofreading domain, and p.Pro1582Ser lies outside that region and is not one of the established hotspot residues. Its relatively high frequency in South Asian populations (up to ~0.4%, with homozygotes) argues against a strongly penetrant pathogenic effect, but the available evidence is not enough to call it benign. It therefore remains a variant of uncertain significance.

Transcript
NM_006231.4
HGVS · transcript:coding
NM_006231.4:c.4744C>T
GRCh38
chr12:132642714 G>A
GRCh37
chr12:133219300 G>A
VUS: the sole met criterion is BS1 (supporting, gnomAD South Asian AF 0.338-0.395% vs >0.3% threshold); no pathogenic criterion or benign combination is satisfied, so no rule beyond Uncertain Significance applies.
Classification rationale
BS1 VUS
POLE c.4744C>T missense · exon 37

BS1 (Supporting): gnomAD South Asian allele frequency 0.338-0.395% exceeds the 0.3% benign-frequency threshold but remains below the 1% BA1 cutoff. Overall classification VUS: with BS1 as the only met criterion, no pathogenic criterion applies and the benign combinations (one strong plus one supporting, or two supporting) are not satisfied.

BS1 VUS
Gene diagram · NM_006231.4 · variants mapped to exon structure
POLE NM_006231.4
Fetching transcript structure from UCSC…
Applied criteria · 1 applied · 26 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 · 1
Strength Supporting Moderate Strong Very strong
BS1 supporting Benign
Met (supporting): gnomAD South Asian frequency of 0.338-0.395% exceeds the 0.3% BS1 threshold while staying below the 1% BA1 cutoff.
gnomAD v4.1 reports the highest population AF in South Asian individuals as 0.33819% (308/91,074 alleles) and grpmax FAF as 0.30709%.gnomAD v2.1 reports the highest population AF in South Asian individuals as 0.39527% (121/30,612 alleles) and grpmax FAF as 0.33803%.gnomAD-Canada independently reports AF 0.02172% overall (4/18,418 alleles), with South Asian AF 0.22026% (3/1,362 alleles), providing additional population evidence but not exceeding 0.3%.
Assessed · not applied · 14 not met · 12 not assessed
Pathogenic
PVS1 Not met: this missense change (p.Pro1582Ser) is not a null variant such as nonsense, frameshift, or splice-site disruption.
PS1 Not assessed: no previously established pathogenic variant producing the same amino acid change (p.Pro1582Ser) via a different nucleotide change was available.
PS2 Not assessed: no parental testing or confirmed de novo occurrence was available to support this criterion.
PS3 Not met: no functional assay evidence exists for this variant; OncoKB lists it as having unknown oncogenic effect.
PS4 Not met: only one somatic occurrence in COSMIC, well below the required recurrent count of at least 10, with no case-control enrichment.
PM1 Not met: residue 1582 lies outside the exonuclease-domain hotspot region (~amino acids 268-471) and is not a statistically significant hotspot.
PM2 Not met: the highest population frequency is 0.338% (gnomAD South Asian), above the 0.1% rarity threshold.
PM3 Not assessed: no data show the variant in trans with a pathogenic POLE variant.
PM4 Not met: p.Pro1582Ser is a single amino-acid substitution with no protein-length alteration.
PM5 Not assessed: no different pathogenic missense change at codon 1582 was available as a comparator.
PM6 Not assessed: no evidence indicates the variant arose de novo.
PP1 Not assessed: no co-segregation data in affected family members were available.
PP2 Not assessed: POLE's rate of benign missense variation could not be evaluated because no gene-level constraint metric was available.
PP3 Not met: REVEL score 0.564 is below the ≥0.773 supporting threshold, and SpliceAI predicts no splice impact.
PP4 Not assessed: no phenotype or phenotype-to-genotype specificity evidence was provided.
PP5 Not met: ClinVar holds no expert-panel pathogenic assertion for this variant, only single-laboratory benign, likely benign, and VUS submissions.
Benign
BA1 Not met: the highest population frequency is 0.395% (gnomAD South Asian), below the 1% BA1 threshold.
BS2 Not assessed: homozygotes exist in gnomAD, but phenotype and penetrance data are lacking to judge this allele benign.
BS3 Not met: no functional assay evidence of normal function exists for this variant.
BS4 Not assessed: no documented lack of segregation in affected relatives was available.
BP1 Not met: missense variants are an established disease mechanism in POLE, so this criterion for truncation-only genes does not apply.
BP2 Not assessed: no allelic observation with established phase (in trans or in cis) was available.
BP3 Not met: this is a missense substitution, not an in-frame insertion or deletion.
BP4 Not met: REVEL score 0.564 is above the ≤0.290 benign threshold, and one benign splice prediction alone is insufficient.
BP5 Not assessed: no evidence of an alternate molecular basis for disease in the tested individual was provided.
BP6 Not met: ClinVar holds no expert-panel benign or likely benign assertion for this variant.
N/A · 1 BP7
Research & evidence
Population frequency
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= 0.000198321; MAF= 0.01983%, 320/1613542 alleles, homozygotes = 4) and has highest observed frequency in the South Asian population (AF= 0.00338187; MAF= 0.33819%, 308/91074 alleles, homozygotes = 4); grpmax FAF= 0.0030709.
v2.1
This variant is present in gnomAD v2.1 (AF= 0.000494477; MAF= 0.04945%, 124/250770 alleles, homozygotes = 2) and has highest observed frequency in the South Asian population (AF= 0.0039527; MAF= 0.39527%, 121/30612 alleles, homozygotes = 2); grpmax FAF= 0.00338032.
🇨🇦 CA
This variant is present in gnomAD-Canada v1.0 (AF= 0.0002171788467803236, 4/18418 alleles, homozygotes = 0).
Allele frequency by ancestry
three datasets · side by side
gnomAD v4.1
0.02% · 320 / 1,613,542
4 hom · FAF 0.31%
South Asian
308 / 91,074
0.34%
4 hom
Remaining individuals
11 / 62,496
0.018%
Admixed American
1 / 60,014
0.0017%
+ 7 not observed (European (Finnish), Amish, East Asian, Middle Eastern, Ashkenazi Jewish, African/African American, European (non-Finnish))
gnomAD v2.1
0.049% · 124 / 250,770
2 hom · FAF 0.34%
South Asian
121 / 30,612
0.4%
2 hom
Remaining individuals
3 / 6,108
0.049%
+ 6 not observed (African/African American, Admixed American, Ashkenazi Jewish, East Asian, European (Finnish), European (non-Finnish))
gnomAD Canada 🇨🇦
0.022% · 4 / 18,418
0 hom · FAF 0.06%
South Asian
3 / 1,362
0.22%
East Asian
1 / 1,338
0.075%
+ 7 not observed (African/African American, Latino/Admixed American, Ashkenazi Jewish, European (Finnish), Middle Eastern, European (non-Finnish), Remaining individuals)
ClinVar screenshot
ClinVar
This variant has been reported in ClinVar as Likely benign (2 clinical laboratories) and as Benign (1 clinical laboratory) and as Uncertain significance (1 clinical laboratory). (ClinVarID = 473690)
SpliceAI screenshot
In silico
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.564. BayesDel score = 0.00154395.
Functional / OncoKB screenshot
Functional Unknown Oncogenic Effect
OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. POLE, the catalytic subunit of DNA polymerase epsilon, is an enzyme involved in DNA replication and repair. Select POLE mutations lead to ultra-high m
OncoKB ↗
COSMIC screenshot
COSMIC
Cancer hotspots screenshot
Cancer hotspots
Somatic evidence Not in COSMIC / hotspots
COSMIC
This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV108850878, n = 1 times).
Hotspots
This variant does not lie in a statistically significant hotspot.
Sources & reference links
8Sources
ClinVar
gnomAD v2.1
gnomAD v4.1
gnomAD-Canada
SpliceAI
OncoKB
COSMIC
Cancer hotspots
Triaged references · 3 PMIDs not cited in assessment
25741868 ↗ Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. CLINVAR
25394175 ↗ A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. CLINVAR
28492532 ↗ Sherloc: a comprehensive refinement of the ACMG-AMP variant classification criteria. CLINVAR