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Updated: Dec 12, 2025

Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Pediatric Somatic Tumor Sequencing Identifies Underlying Cancer Predisposition
Suzanne P MacFarland1, Kristin Zelley1, Lea F Surrey2,3
1Division of Oncology, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
Somatic tumor testing identified potential cancer predisposition syndromes in pediatric cancer patients. Over one-third of concerning variants were constitutionally confirmed, aiding diagnosis beyond clinical history alone.
Area of Science:
- Pediatric Oncology
- Cancer Genomics
- Genetic Predisposition
Background:
- Diagnosing cancer predisposition in pediatric patients is crucial for treatment and family surveillance.
- Somatic tumor testing can reveal constitutional variants linked to increased cancer risk.
Purpose of the Study:
- To characterize constitutional variants identified through somatic tumor testing in pediatric cancer patients.
- To assess the diagnostic yield of somatic tumor testing for cancer predisposition syndromes.
Main Methods:
- Retrospective review of 1,023 pediatric patients undergoing in-house somatic tumor testing over 28 months.
- Analysis of referral criteria, family history, and variant loss of heterozygosity.
- Clinical confirmatory testing for variants concerning for cancer predisposition.
Main Results:
- 210 variants concerning for cancer predisposition were found in 141 patients (13.8%).
- Constitutional confirmation was achieved for 26 of 73 tested variants (35.6%).
- Cancer predisposition syndromes were diagnosed in 23 of 41 tested patients (56.1%).
Conclusions:
- Over one-third of variants initially concerning for cancer predisposition via somatic testing were constitutionally confirmed.
- Somatic tumor testing is effective in identifying potential cancer predisposition syndromes in pediatric patients.
- This approach can uncover syndromes missed by clinical history alone.
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