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PALB2 – Familial Ovarian Cancer Predisposition

PALB2 has been implicated as an autosomal dominant predisposition gene for familial ovarian cancer. A large-scale NGS study of 429 ovarian carcinoma cases versus 557 controls identified germline truncation variants in Fanconi pathway genes, with enrichment of rare PALB2 alleles in 20% of cases (PMID:24448499).

Autosomal dominant inheritance is supported by segregation of a novel PALB2 exon 13 tandem duplication in a hereditary breast and ovarian cancer family, co-segregating with disease in ≥3 affected relatives (PMID:27757719).

Case–control analysis revealed at least 9 distinct PALB2 variants in ovarian cancer patients, including truncating alleles and missense changes. Notably, the frameshift variant c.1240C>T (p.Arg414Ter) recurred among ovarian cases (PMID:24448499).

Functional assays demonstrate that PALB2 serves as the molecular scaffold linking BRCA1 and BRCA2 to RAD51 during homologous recombination. Disruption of PALB2 impaired HR repair in cell models and accelerated tumorigenesis in Palb2-deficient mice (PMID:19369211; PMID:23657012).

Integration of genetic and experimental data yields a Strong gene–disease association: multiple truncating and missense variants in ovarian cohorts, familial segregation, and concordant HR defect models. Testing PALB2 in hereditary ovarian cancer panels enhances risk stratification and guides targeted surveillance and therapy.

References

  • International journal of gynecological cancer • 2020 • Ovarian cancer predisposition beyond BRCA1 and BRCA2 genes. PMID:32895312
  • Nature communications • 2014 • Integrated analysis of germline and somatic variants in ovarian cancer. PMID:24448499
  • Breast cancer research and treatment • 2016 • Characterization of a novel germline PALB2 duplication in a hereditary breast and ovarian cancer family. PMID:27757719
  • Proceedings of the National Academy of Sciences of the United States of America • 2009 • PALB2 is an integral component of the BRCA complex required for homologous recombination repair. PMID:19369211
  • Proceedings of the National Academy of Sciences of the United States of America • 2013 • Palb2 synergizes with Trp53 to suppress mammary tumor formation in a model of inherited breast cancer. PMID:23657012

Evidence Based Scoring (AI generated)

Gene–Disease Association

Strong

9 truncating/missense variants in ovarian cases; segregation in a multiplex family; concordant functional data

Genetic Evidence

Strong

Enrichment of PALB2 truncating and missense variants in 429 cases vs 557 controls; familial segregation of exon 13 duplication

Functional Evidence

Moderate

PALB2 is a core BRCA1–PALB2–BRCA2 scaffold in HR; cell and mouse models recapitulate HR defects