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Functional analysis of RAD51C missense variants reveals 30 deleterious variants impacting DNA repair and increasing breast and ovarian cancer risk, aiding clinical classification.

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Area of Science:

  • Genetics
  • Molecular Biology
  • Cancer Research

Background:

  • Pathogenic protein-truncating variants in RAD51C, a key DNA damage repair gene, are linked to increased breast and ovarian cancer risk.
  • Numerous RAD51C missense variants of uncertain significance (VUS) exist, with their functional impact and cancer predisposition largely uncharacterized.

Purpose of the Study:

  • To functionally assess a large cohort of RAD51C missense variants.
  • To determine the impact of these variants on RAD51C function and their association with cancer risk.

Main Methods:

  • A homology-directed repair (HDR) assay was employed in reconstituted RAD51C-/- cells to evaluate 173 missense variants.
  • Functional assays in reconstituted RAD51C-depleted cancer cells and computational structural analysis were also performed.
  • Case-control association studies were conducted to assess cancer risk in carriers of deleterious variants.

Main Results:

  • Thirty deleterious RAD51C missense variants were identified, with 18 located in a critical ATP-binding region.
  • Deleterious variants impaired RAD51C function, conferred sensitivity to cisplatin and olaparib, and disrupted protein complex formation.
  • These variants showed significant associations with moderate breast cancer risk (OR, 3.92) and high ovarian cancer risk (OR, 14.8).

Conclusions:

  • Functional characterization of RAD51C missense variants provides crucial insights into their role in DNA repair and cancer predisposition.
  • The identified deleterious variants are functionally similar to known pathogenic protein-truncating variants.
  • This data supports classifying inactivating RAD51C missense variants as pathogenic or likely pathogenic, potentially improving clinical management for carriers.