Detection of Germline Mutations in Patients with Epithelial Ovarian Cancer Using Multi-gene Panels: Beyond BRCA1/2

Cancer Res Treat. 2018 Jul;50(3):917-925. doi: 10.4143/crt.2017.220. Epub 2017 Sep 27.

Abstract

Purpose: Next-generation sequencing (NGS) allows simultaneous sequencing of multiple cancer susceptibility genes and may represent a more efficient and less expensive approach than sequential testing. We assessed the frequency of germline mutations in individuals with epithelial ovarian cancer (EOC), using multi-gene panels and NGS.

Materials and methods: Patients with EOC (n=117) with/without a family history of breast or ovarian cancer were recruited consecutively, from March 2016 toDecember 2016.GermlineDNAwas sequenced using 35-gene NGS panel, in order to identify mutations. Upon the detection of a genetic alteration using the panel, results were cross-validated using direct sequencing.

Results: Thirty-eight patients (32.5%) had 39 pathogenic or likely pathogenic mutations in eight genes, including BRCA1 (n=21), BRCA2 (n=10), BRIP1 (n=1), CHEK2 (n=2), MSH2 (n=1), POLE (n=1), RAD51C (n=2), and RAD51D (n=2). Among 64 patients with a family history of cancer, 27 (42.2%) had 27 pathogenic or likely pathogenic mutations, and six (9.3%) had mutations in genes other than BRCA1/2, such as CHECK2, MSH2, POLE, and RAD51C. Fifty-five patients (47.0%) were identified to carry only variants of uncertain significance.

Conclusion: Using the multi-gene panel test, we found that, of all patients included in our study, 32.5% had germline cancer-predisposing mutations. NGS was confirmed to substantially improve the detection rates of a wide spectrum of mutations in EOC patients compared with those obtained with the BRCA1/2 testing alone.

Keywords: Ethnicity; Germ-line mutation; Next-generation sequencing; Prevalence; Ovarian epithelial cancer.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Carcinoma, Ovarian Epithelial
  • Checkpoint Kinase 2 / genetics
  • DNA Polymerase II / genetics
  • DNA-Binding Proteins / genetics
  • Fanconi Anemia Complementation Group Proteins / genetics
  • Female
  • Gene Regulatory Networks*
  • Germ-Line Mutation*
  • High-Throughput Nucleotide Sequencing / methods*
  • Humans
  • Middle Aged
  • MutS Homolog 2 Protein / genetics
  • Mutation Rate
  • Neoplasm Staging
  • Neoplasms, Glandular and Epithelial / genetics*
  • Neoplasms, Glandular and Epithelial / pathology
  • Ovarian Neoplasms / genetics*
  • Ovarian Neoplasms / pathology
  • Poly-ADP-Ribose Binding Proteins / genetics
  • RNA Helicases / genetics
  • Sequence Analysis, DNA / methods*
  • Young Adult

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human
  • DNA-Binding Proteins
  • Fanconi Anemia Complementation Group Proteins
  • Poly-ADP-Ribose Binding Proteins
  • RAD51C protein, human
  • RAD51D protein, human
  • Checkpoint Kinase 2
  • CHEK2 protein, human
  • DNA Polymerase II
  • POLE protein, human
  • MSH2 protein, human
  • MutS Homolog 2 Protein
  • BRIP1 protein, human
  • RNA Helicases