Familial CancerPub Date : 2025-03-20DOI: 10.1007/s10689-025-00452-0
Baoshuai Liu, Shouyu Pan, Xian Hua Gao
{"title":"The current status of care for families with Lynch syndrome in China.","authors":"Baoshuai Liu, Shouyu Pan, Xian Hua Gao","doi":"10.1007/s10689-025-00452-0","DOIUrl":"10.1007/s10689-025-00452-0","url":null,"abstract":"<p><p>Lynch syndrome is one of the most common hereditary cancer predisposition syndromes, which is caused by germline pathogenic variants in mismatch repair genes. It is associated with increased risks of colorectal cancer, endometrial cancer and various other types of cancer. With the rapid development in economy, medicine and genetic tests technology in recent decades, China had achieved significant advancements in the screening, diagnosis and treatment of Lynch syndrome. However, there are still a lot of challenges remaining unresolved. The major challenges include inconsistent access to genetic tests and counseling, regional disparities in healthcare quality, and limited implementation of clinical guidelines. This review will focus on the Chinese current status in the screening of Lynch syndrome, cancer surveillance, preventive measures, patients' willingness to take genetic tests and share genetic information, insurance coverage of medical cost, and national collaboration. At the end, we also summarize the major current research themes in Lynch syndrome in China.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 2","pages":"29"},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-03-18DOI: 10.1007/s10689-025-00453-z
Ane J Schei-Andersen, Vera M Witjes, Janet R Vos, Arjen R Mensenkamp, Anne van Altena, Jolanda Schieving, Michiel Simons, Janneke H M Schuurs-Hoeijmakers, Nicoline Hoogerbrugge
{"title":"Non-serous ovarian cancer in PTEN Hamartoma Tumor Syndrome: additional evidence for increased risk.","authors":"Ane J Schei-Andersen, Vera M Witjes, Janet R Vos, Arjen R Mensenkamp, Anne van Altena, Jolanda Schieving, Michiel Simons, Janneke H M Schuurs-Hoeijmakers, Nicoline Hoogerbrugge","doi":"10.1007/s10689-025-00453-z","DOIUrl":"10.1007/s10689-025-00453-z","url":null,"abstract":"<p><p>Increased hereditary cancer risk is one of the hallmarks of PTEN Hamartoma Tumor Syndrome (PHTS) which is caused by a pathogenic germline variant in PTEN. Case reports and some cohort studies have described ovarian cancer (OC) in PHTS patients. Previously, we observed an enrichment of non-serous OC in PHTS compared to sporadic cases (3% vs 1%). However, ovarian cancer is currently not considered a PHTS-related cancer. The aim of this study was to describe five PHTS patients with a pathogenic germline variant in PTEN with non-serous OC. Three of the non-serous OCs were mucinous carcinomas (49, 51 and 52 years) and two were malignant germ cell tumors (8 and 15 years) and all were diagnosed before genetic testing and PHTS diagnosis. In addition to OC, the described patients developed other PHTS-related benign and malignant lesions. We provide further evidence that non-serous ovarian cancer, especially mucinous, endometrioid and malignant germ cell tumors should be further investigated as potential PHTS-related cancers.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 2","pages":"28"},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-03-06DOI: 10.1007/s10689-025-00451-1
Avani Varde, Terri McVeigh, Vicky Cuthill, Angela F Brady, Bianca DeSouza, Andrew Latchford, Kevin J Monahan
{"title":"Addressing uncertainty in hereditary colorectal cancer: the role of a regional expert multidisciplinary team meeting.","authors":"Avani Varde, Terri McVeigh, Vicky Cuthill, Angela F Brady, Bianca DeSouza, Andrew Latchford, Kevin J Monahan","doi":"10.1007/s10689-025-00451-1","DOIUrl":"10.1007/s10689-025-00451-1","url":null,"abstract":"<p><p>There is frequent uncertainty in both the precise quantification of risk, and the application of clinical interventions, designed to mitigate increased heritable colorectal cancer (CRC) susceptibility. We evaluated the role of a collaborative specialist multidisciplinary team meeting (MDM) for familial and hereditary CRC, led by the St Mark's Hospital Centre for Familial Intestinal Cancer specifically in supporting the clinical management of uncertainty. A retrospective thematic analysis of meeting outcomes from inception in June 2020 until March 2023 was performed. Descriptive statistics were employed to ascertain clinicopathological data, clinical queries and whether MDM recommendations were outside the scope of current guidelines. In total 260 cases were discussed from 13 regional institutions. A prior personal history of cancer was present in 215 (82.6%), and a family history of CRC in 107(41.2%) and non-CRC 27(10.4%) cases. In thematic analysis uncertainty related to indications for genetic testing was considered in 148 (56.9%) of cases, with unexplained mismatch repair deficiency (u-dMMR) in 78 (30%) of cases, and resolution of molecular interpretation in 61 (23.5%). Surveillance related queries represented 55 (21.1%), and mainstreaming 29 (11%) of cases. Management was recommended beyond the scope of existing guidelines in 64 (24.6%) cases. This regional hereditary CRC MDM provides clinicians with support in areas of uncertainty in diagnosis and clinical management, supporting clinical decision-making where evidence and clinical guidelines may be limited. This model could be replicated to support complexity in clinical care in other geographical regions or other health conditions.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"26"},"PeriodicalIF":1.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-02-26DOI: 10.1007/s10689-025-00450-2
Serene Ong, Zi Yang Chua, Jeanette Yuen, Jianbang Chiang, Zhang Zewen, Joanne Ngeow, Tamra Lysaght
{"title":"Healthcare provider-mediated cascade testing of Lynch syndrome to at-risk family members: an interview study.","authors":"Serene Ong, Zi Yang Chua, Jeanette Yuen, Jianbang Chiang, Zhang Zewen, Joanne Ngeow, Tamra Lysaght","doi":"10.1007/s10689-025-00450-2","DOIUrl":"10.1007/s10689-025-00450-2","url":null,"abstract":"<p><p>Cascade testing is often recommended for cancer predisposition syndromes, like Lynch syndrome (LS), to identify at-risk family members. The uptake of cascade testing is typically meditated by the proband's willingness to disclose their results with family members. Of which, cascade testing uptake rates in Singapore has been low, compared to global rates. Studies suggest that healthcare providers (HCPs)-meditated contact of at-risk family improves uptake, yet few have explored how receptive probands and family members are to such a model. Moreover, no studies to date have examined such a model of cascade testing in Asia. To address this gap, we interviewed 17 participants (probands and relatives) in Singapore to evaluate the acceptability and feasibility of HCP-mediated cascade testing for families with LS. Our findings show broad acceptability for HCP-mediated disclosure to relatives, driven by a sense of beneficence. However, HCP involvement introduced three unique issues to disclosure process: (i) their clinical position, which conveys expertise and authority; (ii) relational complexities within family dynamics; and (iii) the notion of family-centric privacy. We propose that HCP-mediated disclosure may be best implemented through a cooperative and flexible process, tailored to each family's unique circumstances. This approach balances the efficiency of providing accurate genetic information whilst sensitively navigating familial relationships, thereby improving uptake while respecting cultural and relational nuances.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"25"},"PeriodicalIF":1.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-02-26DOI: 10.1007/s10689-025-00449-9
Fernández Mercè, Queralt Asla, Francisco J Illana, Fusté Victòria, Hernández-Losa Javier, Sesé Marta, Carmela Iglesias, Susan M Webb, Anna Aulinas
{"title":"A novel likely pathogenic germline variant in CDKN1B in a patient with MEN4 and medullary thyroid cancer.","authors":"Fernández Mercè, Queralt Asla, Francisco J Illana, Fusté Victòria, Hernández-Losa Javier, Sesé Marta, Carmela Iglesias, Susan M Webb, Anna Aulinas","doi":"10.1007/s10689-025-00449-9","DOIUrl":"10.1007/s10689-025-00449-9","url":null,"abstract":"<p><p>Multiple endocrine neoplasia type 4 (MEN4) is caused by a germline CDKN1B deleterious variant. CDKN1B encodes p27Kip1, a cyclin-dependent kinase inhibitor that acts as tumor-suppressor. Clinical presentation of MEN4 is similar to multiple endocrine neoplasia type 1 (MEN1) but the diagnosis of MEN4 can only be established once a germline CDKN1B pathogenic variant has been confirmed. We describe a unique case presenting with two -rare endocrine conditions. A 59-year-old female patient was diagnosed with medullary thyroid cancer (MTC) without evidence of a germline pathogenic variant in the RET proto-oncogene. Five years later, she developed Cushing's disease. A heterozygous germline variant was identified in the CDKN1B gene, specifically c.536del (p.Prol179GlnfsTer46), corresponding to a single-nucleotide deletion at position 536. This variant induces a frameshift, leading to an alternative stop codon. Immunostaining of the pituitary and thyroid tumors revealed a weak nuclear expression of p27/Kip1 without significant differences of expression between tumor and non-tumoral tissues. The NGS panel (Oncomine Comprehensive Assay v3) performed in both MTC and pituitary tissues identified the germline CDKN1B variant, as well as a pathogenic missense somatic variant c.182 A > G, p.(Gln61Arg) in HRAS in the MTC, without any RET somatic pathogenic variant. Evaluation of loss of heterozygosity (LOH) in both MTC and pituitary tissues showed compatibility with copy-neutral LOH, although further evidence is required for definitive confirmation. In conclusion, we report a clinical case of MTC coexisting with MEN4 due to a novel CDKN1B germline heterozygote frameshift variant.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"24"},"PeriodicalIF":1.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-02-18DOI: 10.1007/s10689-025-00448-w
Luiza N Weis, Brittany L Bychkovsky, Adela Rodríguez Hernandez, Romualdo Barroso-Sousa, Renata L Sandoval
{"title":"CHEK2-related breast cancer: real-world challenges.","authors":"Luiza N Weis, Brittany L Bychkovsky, Adela Rodríguez Hernandez, Romualdo Barroso-Sousa, Renata L Sandoval","doi":"10.1007/s10689-025-00448-w","DOIUrl":"10.1007/s10689-025-00448-w","url":null,"abstract":"<p><strong>Purpose: </strong>Management of cancer risks associated with the CHEK2 gene, a moderate penetrance breast cancer gene, is challenging in real-world practice. Family history, traditional breast cancer risk factors, and specific genetic CHEK2 variants are risk modifiers in this setting and add complexity for surveillance and risk-reduction decisions. Here, we present a case series of Brazilian CHEK2 carriers affected by breast cancer.</p><p><strong>Methods: </strong>Patients evaluated in the Oncogenetics Department of Hospital Sírio-Libanês (Brasília, Brazil) between November 2017 and September 2021, who had a personal history of breast cancer and a germline genetic test with a pathogenic or likely pathogenic CHEK2 variant, were selected for case description. Clinical pearls and knowledge gaps were highlighted for each case.</p><p><strong>Results: </strong>Twelve women were included in this descriptive analysis. All patients had early-stage breast cancer. Most of them were diagnosed with breast cancer prior to age 50 (9/12) and had a close relative affected by breast cancer (9/12). Seven patients harbored intronic pathogenic variants. Clinical pearls included the following: lack of risk estimates for intronic CHEK2 variants among non-European ancestry CHEK2 carriers, environmental exposures as a risk modifier, notable non-breast cancer diagnosis at young ages, incidental germline finding during tumor profiling, breast cancer diagnosis before the recommended age of breast cancer screening, family history of breast cancer as a risk modifier, and clinical outcomes after breast cancer treatment.</p><p><strong>Conclusions: </strong>Improvements in cancer risk assessment and cancer prevention for CHEK2 carriers are still needed to overcome current clinical challenges on the management of these patients.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"23"},"PeriodicalIF":1.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Familial CancerPub Date : 2025-02-07DOI: 10.1007/s10689-025-00445-z
Morgane Boedec, Camille Aucouturier, Mathias Cavaillé, Raphaël Leman, Laurent Castéra, Hélène Delhomelle, Nancy Uhrhammer, Virginie Bernard, Sophie Giraud, Eulalie Lasseaux, Natalie Jones, Marie Bidart, Nadia Boutry-Kryza, Catherine Noguès, Chrystelle Colas, Christine Maugard, Sophie Krieger, Ahmed Bouras
{"title":"Identification of a germline deep intronic PTEN-deletion leading to exonization through whole genome and targeted RNA sequencing.","authors":"Morgane Boedec, Camille Aucouturier, Mathias Cavaillé, Raphaël Leman, Laurent Castéra, Hélène Delhomelle, Nancy Uhrhammer, Virginie Bernard, Sophie Giraud, Eulalie Lasseaux, Natalie Jones, Marie Bidart, Nadia Boutry-Kryza, Catherine Noguès, Chrystelle Colas, Christine Maugard, Sophie Krieger, Ahmed Bouras","doi":"10.1007/s10689-025-00445-z","DOIUrl":"10.1007/s10689-025-00445-z","url":null,"abstract":"<p><p>PTEN Hamartoma Tumor Syndrome (PHTS) is an autosomal dominant disorder characterized by high penetrance and significant phenotypic variability. In most patients, targeted high-throughput sequencing (HTS) approaches enable the detection of loss-of-function pathogenic variants in PTEN, a tumor suppressor gene acting as a negative regulator of the PI3K-AKT pathway. We describe a patient exhibiting a clinical phenotype strongly indicative of PHTS, yet lacking a molecular diagnosis through PTEN-targeted HTS. After several years of diagnostic uncertainty, trio whole genome sequencing (WGS) ultimately identified a de novo germline deep intronic 98 bp deletion in PTEN intron 5 (c.492 + 1671_492 + 1768del). Targeted RNA sequencing revealed the inclusion of a pseudoexon, resulting in a frameshift and predicted protein truncation at codon 171 (p.Val166Asnfs*6). These data underline the importance of WGS approaches in detecting deep intronic structural variants, that may be overlooked by conventional methods.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"21"},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New RPS20 gene variant in colorectal cancer diagnosis: insight from a large series of patients.","authors":"Julie Amiot, Lara Gubeljak, Agathe Fontaine, Denis Smith, Isabelle Mortemousque, Nathalie Parodi, Jacques Mauillon, Edwige Kasper, Stéphanie Baert-Desurmont, Julie Tinat, Claude Houdayer","doi":"10.1007/s10689-025-00446-y","DOIUrl":"10.1007/s10689-025-00446-y","url":null,"abstract":"<p><p>Germline pathogenic variants of the RPS20 (ribosomal protein S20) gene are suspected to be involved in the predisposition to familial colorectal cancer (CRC) with no DNA mismatch repair deficiency. RPS20 pathogenic variants are very rare with only five reported cases in the literature. We report in this work the retrospective germline analysis of RPS20 for 1035 consecutive patients with a personal and/or familial history suggestive of hereditary predisposition to CRC. Within this series, a pathogenic variant in known CRC genes was found in 15% of cases and we describe one RPS20 loss-of-function variant (NM_001146227.1:c.115_116del, p.(Leu39Aspfs*33)). This frameshift is the first reported de novo variant in CRC, it was identified in in a female patient diagnosed with rectal cancer at the age of 35, 11 adenomatous polyps in 5 years and breast cancer at the age of 43. RPS20 has an intriguing role in oncogenesis, acting as an oncogene or tumour suppressor depending on the context, and is also involved in Diamond-Blackfan anemia via gain of function or dominant negative variants. This is therefore a complex gene for genetic counselling and, given the rarity of RPS20 pathogenic variants, we emphasise the need to collect data to clarify the phenotypic spectrum of RPS20-associated cancers and thus improve management.</p>","PeriodicalId":12336,"journal":{"name":"Familial Cancer","volume":"24 1","pages":"22"},"PeriodicalIF":1.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}