Functional Assessment of Genetic Variants with Outcomes Adapted to Clinical Decision-Making

PLoS Genet. 2016 Jun 6;12(6):e1006096. doi: 10.1371/journal.pgen.1006096. eCollection 2016 Jun.

Abstract

Understanding the medical effect of an ever-growing number of human variants detected is a long term challenge in genetic counseling. Functional assays, based on in vitro or in vivo evaluations of the variant effects, provide essential information, but they require robust statistical validation, as well as adapted outputs, to be implemented in the clinical decision-making process. Here, we assessed 25 pathogenic and 15 neutral missense variants of the BRCA1 breast/ovarian cancer susceptibility gene in four BRCA1 functional assays. Next, we developed a novel approach that refines the variant ranking in these functional assays. Lastly, we developed a computational system that provides a probabilistic classification of variants, adapted to clinical interpretation. Using this system, the best functional assay exhibits a variant classification accuracy estimated at 93%. Additional theoretical simulations highlight the benefit of this ready-to-use system in the classification of variants after functional assessment, which should facilitate the consideration of functional evidences in the decision-making process after genetic testing. Finally, we demonstrate the versatility of the system with the classification of siRNAs tested for human cell growth inhibition in high throughput screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • BRCA1 Protein / genetics
  • Breast Neoplasms / genetics*
  • Clinical Decision-Making
  • Female
  • Genetic Counseling / methods
  • Genetic Predisposition to Disease / genetics*
  • Genetic Testing / methods
  • Genetic Variation / genetics*
  • Humans
  • Mutation, Missense / genetics
  • Ovarian Neoplasms / genetics*

Substances

  • BRCA1 Protein
  • BRCA1 protein, human

Grants and funding

GAM's research is supported by grants Association pour la Recherche sur le Cancer (ARC) PJA 2013 1200463, Institut Curie CEST 2011 95011, CEST 2012 95023, CEST 2013 95030 and PIC "Cellular models and Clinical Scenario" 2013 91920. EDN's research is supported by grant Paris Alliance of Cancer Research Institutes (PACRI) - Agence Nationale de la Recherche ANR-11-PHUC-002. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.