Abstract

PALB2 is an important BRCAx candidate for familial breast cancers (FBC). PALB2 pathogenic variants (PVs) may not to conform to “two hit” paradigm. However, a recent study demonstrates that in the majority PALB2 germline mutant breast cancers, the loss of heterozygosity (LOH) and somatic point mutations are the “second hit.” This study aimed to investigate the second hits in germline PALB2 mutations in breast cancers. We screened out 28 germline PALB2-mutation carriers among 480 familial cancer patients (including 143 FBC patients) in Geneplus database pool. Of the 143 patients with FBC, 10 had mono-allelic PALB2 germline mutations. All these germline PALB2 mutations were high-risk stop-gain, frameshift, or splicing mutations that concentrated in EX5–EX9 and might led to truncated proteins, severe functional defects and malignant phenotype. The hotspots were c.1057A[3 > 2] and c.3114-1G > A. Other mutations included c.389delA, c.2068C > T, c.2167_2168delAT, c.2629delT and c.2968G > T. Only one FBC patient has PALB2 somatic mutation and two patients had LOH of PALB2. All germline PALB2 mutations were high-risk mutations, whereas the somatic PALB2 mutations were moderate-risk missense mutations. We also distinguished PALB2 “novel mutations” from “reported mutations.” In conclusion, germline PALB2 mutation should be put into the context of future screening.

Highlights

  • The one-eighth of females develop breast cancer over the course of their lifetime (Owens et al, 2019)

  • By screening circulating tumor DNA (ctDNA) from 10 PALB2-associated hereditary breast cancer (HBC) and 30 sporadic advanced breast cancer (ABC), we found that the PALB2-associated tumors had a different mutational signature from the sporadic tumors (Figure 1)

  • Most of the heterozygous germline PALB2 LOF mutations were not accompanied by PALB2 somatic mutations or loss of heterozygosity (LOH)

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Summary

Introduction

The one-eighth of females develop breast cancer over the course of their lifetime (Owens et al, 2019). 5–27% of breast cancers are hereditary (Lichtenstein et al, 2000). BRCA1 was the first gene identified as a susceptibility gene for hereditary breast cancer (HBC) (Torchard et al, 1994). BRCA2 was identified as a susceptibility gene for HBC (Collins et al, 1995). 70–80% of HBCs involve nonBRCA1/2 (BRCAx) mutations (Hedenfalk et al, 2003; Keeney et al, 2017). ATM, CHD8, Germline and Somatic PALB2 Mutation

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