One of these is not like the others: A descriptive study of the attenuated phenotype of PMS2.

Authors

Edward Esplin

Edward D. Esplin

Invitae, San Francisco, CA

Edward D. Esplin , Brandie Heald , Sarah M. Nielsen , Rachel Ellsworth , Emily M. Russell , Daniel Esteban Pineda Alvarez

Organizations

Invitae, San Francisco, CA

Research Funding

No funding sources reported

Background: Data from Lynch syndrome (LS) registries reveal that patients (pts) with PMS2 pathogenic germline variants (PGVs) have the lowest cancer risk. This retrospective study of pts undergoing germline genetic testing (GGT) for any indication compared the phenotypes of PMS2 carriers to other LS pts. We hypothesized that PMS2 pts were more likely to have no cancer or non–LS associated cancers than other LS pts. Methods: All Pts with a single PGV in any LS gene were identified from a commercial laboratory database. Demographics and personal and family cancer history data were clinician-reported on the test requisition form. Data from PMS2 pts were compared to MSH6 and MLH1/MSH2/EPCAM pts using descriptive statistics, unpaired two-samples t tests, Chi-square tests, and multivariate logistic regression analyses that also included patients with no PGVs, with p<0.05 defining significance. Results: 17,711 pts met inclusion criteria (5,189 PMS2, 5,182 MSH6, and 7,340 MLH1/MSH2/EPCAM). PMS2 pts were significantly older at testing (mean 55.1±16.0y) than MLH1/MSH2/EPCAM (48.7±15.7y) and had significantly less family cancer history (84.9%) than both MSH6 (86.8%) and MLH1/MSH2/EPCAM (86.6%) pts. PMS2 pts had lower odds of any colorectal and uterine cancers than the MSH6 and MLH1/MSH2/EPCAM cohorts (Table). All LS-related PGVs were significantly associated with lower odds of breast, pancreatic, and prostate cancer. Conclusions: Pts with PMS2 PGVs were older at the time of testing and had lower odds of any and LS-related cancers than other LS pts. These data are consistent with prior registry studies and can aid in counseling and management of PMS2 pts.

Results of multivariate logistic regression analyses; each adjusted for sex, age, family history, ethnicity, and number of genes analyzed. Multiple testing correction for p-value and CI based on number of outcomes (10) and genes (3) with α = 0.004.

CancerCohortORCIp-value
ColorectalPMS23.53.01-4.05<2E-16
MSH65.494.80-6.27<2E-16
MLH1/MSH2/EPCAM11.1710.01-12.47<2E-16
UterinePMS23.783.02-4.67<2E-16
MSH612.0610.24-14.16<2E-16
MLH1/MSH2/EPCAM9.067.60-10.75<2E-16
OvarianPMS20.880.62-1.190.094
MSH61.040.75-1.390.632
MLH1/MSH2/EPCAM1.270.94-1.680.000713
GastricPMS21.030.52-1.810.849
MSH60.950.47-1.700.768
MLH1/MSH2/EPCAM1.711.14-2.456.45E-09
PancreaticPMS20.620.40-0.911.33E-06
MSH60.520.33-0.784.65E-10
MLH1/MSH2/EPCAM0.450.28-0.689.91E-14
ProstatePMS20.420.29-0.59<2E-16
MSH60.330.22-0.46<2E-16
MLH1/MSH2/EPCAM0.320.23-0.45<2E-16
BreastPMS20.480.40-0.56<2E-16
MSH60.320.27-0.38<2E-16
MLH1/MSH2/EPCAM0.210.17-0.26<2E-16
AnyPMS20.860.75-0.981.73E-06
MSH61.141.00-1.306.07E-05
MLH1/MSH2/EPCAM1.841.64-2.08<2E-16
MultiplePMS21.531.35-1.742E-16
MSH62.992.69-3.312E-16
MLH1/MSH2/EPCAM3.062.77-3.382E-16

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session C: Cancers of the Colon, Rectum, and Anus

Track

Colorectal Cancer,Anal Cancer

Sub Track

Prevention, Screening, and Hereditary Cancers

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 76)

DOI

10.1200/JCO.2024.42.3_suppl.76

Abstract #

76

Poster Bd #

E19

Abstract Disclosures

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