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PTEN Promoter Variants Are Not Associated With Common Cancers: Implications for Multigene Panel Testing
Mary Helen Black1, Shuwei Li1, Tina Pesaran1
1Mary Helen Black, Shuwei Li, Tina Pesaran, Holly LaDuca, Rachid Karam, Jacob Clifford, and Brandon Smith, Ambry Genetics, Aliso Viejo, CA; and Robert Pilarski, The Ohio State University, Columbus, OH.
PTEN promoter variants do not increase cancer risk. PTEN mutations are linked to certain cancers, but promoter variants lack association, suggesting they shouldn't be included in multigene panel testing.
Area of Science:
- Oncology
- Genetics
- Cancer Research
Background:
- PTEN mutations are established drivers in various cancers, including breast, colon, endometrial, kidney, and thyroid.
- However, most PTEN promoter alterations are classified as variants of unknown significance (VUS), leaving their role in cancer etiology unclear.
Purpose of the Study:
- To investigate the association between PTEN promoter variants and cancer risk.
- To determine if PTEN promoter sequencing should be incorporated into multigene panel testing (MGPT).
Main Methods:
- Retrospective review of personal and family histories from 88,333 patients who underwent PTEN analysis via MGPT.
- Comparison of cancer incidence between individuals with pathogenic PTEN mutations (PATHO), PTEN promoter variants (PROM), and wild-type (WT) PTEN.
- Multivariable logistic regression adjusted for demographic and clinical factors.
Main Results:
- Pathogenic PTEN mutations (PATHO) were significantly associated with increased odds of breast (OR=2.30) and uterine/endometrial cancers (OR=7.56).
- PTEN promoter variants (PROM) showed no significant association with any cancer type compared to wild-type (WT) individuals (all P > .05).
Conclusions:
- PTEN promoter variants are not associated with an increased risk of cancer.
- The findings do not support the routine inclusion of PTEN promoter sequencing within MGPT for cancer risk assessment.
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