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CDKN2B – Renal Cell Carcinoma Predisposition

Germline variants in CDKN2B, encoding the p15^INK4b^ cyclin-dependent kinase inhibitor, have been implicated in inherited renal cell carcinoma (PMID:35422439; PMID:25873077). The association with renal cell carcinoma is supported by multiple independent probands, segregation in a familial kindred, and functional studies demonstrating loss of tumor suppressor activity.

Autosomal dominant inheritance is established by exome resequencing of a familial renal carcinoma kindred in which a heterozygous CDKN2B nonsense variant co-segregated with disease (PMID:25873077). Targeted resequencing of 82 individuals with features of inherited RCC identified three additional missense variants—c.256G>A (p.Asp86Asn), c.68C>A (p.Ala23Glu) and c.118C>A (p.Pro40Thr)—in unrelated probands, yielding a total of five affected individuals across four kindreds (PMID:25873077; PMID:35422439).

A de novo germline 9p21.3 microdeletion encompassing CDKN2A and CDKN2B was reported in a young woman with six primary cancers, including early-onset renal cell carcinoma, supporting a contiguous gene deletion syndrome with additive risk beyond single-gene haploinsufficiency (PMID:35422439).

Functional characterization of the p.Asp86Asn, p.Ala23Glu and p.Pro40Thr missense substitutions revealed impaired CDKN2B-mediated inhibition of cell proliferation in renal carcinoma cell lines, consistent with loss-of-function and haploinsufficiency as the pathogenic mechanism (PMID:25873077).

No large-scale case–control studies have identified frequent germline CDKN2B mutations in unselected RCC cohorts, underscoring the rarity but high penetrance of these variants. Experimental and familial linkage data converge on a model in which CDKN2B haploinsufficiency disrupts cell-cycle control, predisposing to renal tumorigenesis.

Key Take-home: Germline CDKN2B loss-of-function variants confer autosomal dominant predisposition to renal cell carcinoma, warranting inclusion of CDKN2B in genetic testing panels for familial and early-onset RCC.

References

  • Cold Spring Harbor Molecular Case Studies • 2022 • 9p21.3 Microdeletion involving CDKN2A/2B in a young patient with multiple primary cancers and review of the literature. PMID:35422439
  • Cancer Discovery • 2015 • Germline Mutations in the CDKN2B Tumor Suppressor Gene Predispose to Renal Cell Carcinoma. PMID:25873077

Evidence Based Scoring (AI generated)

Gene–Disease Association

Strong

Five probands across four kindreds with germline CDKN2B variants, segregation in one family, and concordant functional impairment

Genetic Evidence

Moderate

One family with a segregating nonsense variant and three unrelated missense loss‐of‐function probands plus a de novo deletion case

Functional Evidence

Moderate

In vitro assays demonstrate impaired proliferation suppression for multiple CDKN2B missense variants