新しい遺伝子解析法により遺伝性がんリスクの判定が可能に(More women can now get answers about their hereditary risk of breast and ovarian cancer due to new genetic method)

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2025-06-18 コペンハーゲン大学(UCPH)

コペンハーゲン大学とRigshospitaletの研究者らが、BRCA2遺伝子変異の病原性を正確に分類できる新しいCRISPR-Select法を開発した。従来は意義不明変異(VUS)の多さが診断や治療の障害となっていたが、本手法により臨床現場での判断が可能となり、乳がん・卵巣がんのリスク評価が大幅に向上。早期予防や適切な治療選択が期待される。この成果は『Journal of Clinical Investigation』に掲載され、精密医療の進展に貢献する。

<関連情報>

BRCA2-PALB2結合変異体の臨床的分類を促進する精密スクリーニングの有用性 Precision screening facilitates clinical classification of BRCA2-PALB2 binding variants with benign and pathogenic functional effects

Muthiah Bose, Manika Indrajit Singh, Morten Frödin, Bent Ejlertsen, Claus S. Sørensen, and Maria Rossing
The Journal of Clinical Investigation  Published: April 15, 2025
DOI:https://doi.org/10.1172/JCI181879

新しい遺伝子解析法により遺伝性がんリスクの判定が可能に(More women can now get answers about their hereditary risk of breast and ovarian cancer due to new genetic method)

Abstract

BACKGROUND. Decoding the clinical impact of genetic variants is particularly important for precision medicine in cancer. Genetic screening of mainly patients with breast and ovarian cancer has identified numerous BRCA1/BRCA2 variants of uncertain significance (VUS) that remain unclassified owing to a lack of pedigrees and functional data.

METHODS. Here, we used CRISPR-Select — a technology that exploits unique inbuilt controls at the endogenous locus — to assess 54 rare ClinVar VUS located in the PALB2-binding domain of BRCA2. Variant deleteriousness was examined in the absence and presence of PARPi, cisplatin, or mitomycin C.

RESULTS. Marked functional deficiency was observed for variants in the exon 2 donor splice region (A22 = c.66A>C, A22 = c.66A>G, A22 = c.66A>T, and D23H) and Trp31 aa (W31G, W31L, and W31C), both critical for BRCA2 function. Moreover, T10K and G25R resulted in an intermediate phenotype, suggesting these variants are hypomorphic in nature. Combining our functional results with the latest ClinGen BRCA1/2 Variant Curation Expert Panel recommendations, we classified 49 of the 54 VUS as either likely benign (n = 45) or likely pathogenic (n = 4).

CONCLUSION. Therefore, CRISPR-Select is an important tool for efficient variant clinical classification. Application of this technology in the future will ultimately improve patient care.

FUNDING. Danish Cancer Society, Novo Nordisk Foundation, Sygeforsikring Danmark, Børnecancerfonden, Neye-Fonden, Roche, Novartis, Pfizer, AstraZeneca, MSD, and Daiichi Sankyo Europe GmbH.

医療・健康
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