학술논문

Prospective pan-cancer germline testing using MSK-IMPACT informs clinical translation in 751 patients with pediatric solid tumors
Document Type
article
Source
Nature Cancer. 2(3)
Subject
Rare Diseases
Genetic Testing
Genetics
Pediatric
Human Genome
Clinical Research
Pediatric Cancer
Cancer
Aetiology
2.1 Biological and endogenous factors
Detection
screening and diagnosis
4.2 Evaluation of markers and technologies
Good Health and Well Being
Child
Genetic Predisposition to Disease
Germ Cells
Germ-Line Mutation
Humans
Neoplasms
Prospective Studies
Language
Abstract
The spectrum of germline predisposition in pediatric cancer continues to be realized. Here we report 751 solid tumor patients who underwent prospective matched tumor-normal DNA sequencing and downstream clinical use (clinicaltrials.gov NCT01775072). Germline pathogenic and likely pathogenic (P/LP) variants were reported. One or more P/LP variants were found in 18% (138/751) of individuals when including variants in low, moderate, and high penetrance dominant or recessive genes, or 13% (99/751) in moderate and high penetrance dominant genes. 34% of high or moderate penetrance variants were unexpected based on the patient's diagnosis and previous history. 76% of patients with positive results completed a clinical genetics visit, and 21% had at least one relative undergo cascade testing as a result of this testing. Clinical actionability additionally included screening, risk reduction in relatives, reproductive use, and use of targeted therapies. Germline testing should be considered for all children with cancer.