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    1. Integrated approach to functional analysis of an ERBB2 variant of unknown significance detected by a cancer gene panel test

      [Paper-level Aggregated] PMCID: PMC8881279

      Evidence Type(s): Oncogenic, Functional, Predictive

      Justification: Oncogenic: The evidence indicates that the ERBB2 E401G variant enhances C-terminal phosphorylation and increases invasive capacity in cancer cells, suggesting its role in promoting oncogenic properties. Functional: The study demonstrates that ERBB2 E401G has functional properties similar to known activating mutations, affecting dimerization and phosphorylation mechanisms, which are critical for its role in signaling pathways. Predictive: The identification of the ERBB2 E401G variant as a variant of unknown significance (VUS) and its evaluation through computational tools predicting pathogenicity suggest its potential as a predictive marker for therapeutic targeting.

      Gene→Variant (gene-first): MYC(4609):1157A > G FANCC(2176):E401G ERBB2(2064):D845A TP53(7157):E321G ERBB2(2064):S310F FANCC(2176):p.(E401G)

      Genes: MYC(4609) FANCC(2176) ERBB2(2064) TP53(7157)

      Variants: 1157A > G E401G D845A E321G S310F p.(E401G)

    2. We found that ERBB2 E401G enhances C-terminal phosphorylation in a way similar to S310F. MD simulation analysis revealed that these variants maintain the stability of the EGFR-HER2 heterodimer in a ligand-independent man

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 6

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F alter molecular function by enhancing C-terminal phosphorylation and maintaining the stability of the EGFR-HER2 heterodimer. Oncogenic: The passage indicates that ERBB2 E401G-transduced cells exhibit increased tumor growth capacity in vivo, suggesting that this variant contributes to tumor development or progression.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    3. ERBB2 E401G was selected as VUS for analysis because multiple software tools predicted its pathogenicity. We prepared ERBB2 expression vectors with the E401G variant as well as vectors with S310F and E321G, which are kno

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 4

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses the evaluation of the phosphorylation of human epidermal growth factor receptor 2 and related proteins, as well as the investigation of the biological effects of the ERBB2 E401G variant, indicating an alteration in molecular function. Oncogenic: The mention of S310F and E321G as known activating mutations suggests that these variants contribute to tumor development or progression, aligning with the oncogenic evidence type.

      Gene→Variant (gene-first): 7157:E321G 2176:E401G 2064:S310F

      Genes: 7157 2176 2064

      Variants: E321G E401G S310F

    4. Dealing with variants of unknown significance (VUS) is an important issue in the clinical application of NGS-based cancer gene panel tests. We detected a novel ERBB2 extracellular domain VUS, c.1157A > G p.(E401G), in a

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 2

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the aim to clarify the biological functions of the ERBB2 E401G variant, indicating an interest in how this variant alters molecular or biochemical function.

      Gene→Variant (gene-first): 4609:1157A > G 2176:E401G

      Genes: 4609 2176

      Variants: 1157A > G E401G

    5. To examine tumor forming capacity in vivo, we constructed H460 cells that stably express ERBB2 (Fig. 8a) and assessed tumor growth after subcutaneous inoculation of these cells into mice. On the 21st day after transplant

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 17

      Evidence Type(s): Oncogenic

      Justification: Oncogenic: The passage discusses the tumor forming capacity of cells expressing the ERBB2 E401G variant, indicating that this somatic variant contributes to tumor development as evidenced by increased tumor growth in vivo.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    6. To examine the biologic effects of ERBB2 E401G in cancer cells, we evaluated the proliferative and invasive capacities of H460 cells. We found that cells expressing ERBB2 S310F exhibited a significantly higher proliferat

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 16

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses the effects of the ERBB2 E401G and S310F variants on the proliferative and invasive capacities of cancer cells, indicating that these variants alter molecular or biochemical functions related to cell behavior. Oncogenic: The evaluation of the proliferative and invasive capacities of cells expressing the ERBB2 variants suggests that these somatic variants contribute to tumor development or progression.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    7. Our simulation data showed that the activating mechanisms of ERBB2 E401G and S310F were related to the EGFR-HER2 heterodimer. The dimerization partner appears to be an important determinant of signaling activity. The two

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 14

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F alter the phosphorylation of downstream signaling pathway proteins, indicating a change in molecular function related to the MAPK pathway. Oncogenic: The evidence suggests that the variants contribute to tumor development or progression by activating signaling pathways associated with cancer, specifically through the ERBB2 dimerization and its effects on downstream signaling.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    8. In a previous simulation study, the dimer interfaces of both the EGFR homodimer and the EGFR-HER2 heterodimer were destabilized when the EGFR lost EGF (a specific ligand of EGFR). We therefore conducted MD simulations of

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 12

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses how the E401G and S310F mutations affect the dimer interface stability of the EGFR-HER2 complex, indicating that these variants alter molecular interactions and stability.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    9. To confirm whether HER2 homodimers or EGFR-HER2 heterodimers are more relevant to the mechanisms of ERBB2 E401G and S310F activation, we analyzed HER-family dimers using microsecond-timescale MD simulations. With regard

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 11

      Evidence Type(s): None

      Justification: Not enough information in this passage.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    10. HER2 p.(E401G) stabilizes ligand-free EGFR HER2 heterodimer

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 10

      Evidence Type(s): Functional

      Justification: Functional: The passage indicates that the variant p.(E401G) alters the stability of the ligand-free EGFR HER2 heterodimer, which suggests a change in molecular function.

      Gene→Variant (gene-first): 2176:p.(E401G)

      Genes: 2176

      Variants: p.(E401G)

    11. C-terminal phosphorylation of HER family proteins is caused by dimerization followed by trans-autophosphorylation, in which one receptor subunit of the dimer phosphorylates the other. Among the HER family proteins, EGFR,

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 9

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F lead to increased phosphorylation levels of HER2 and EGFR, indicating that these variants alter molecular function related to protein activity. Oncogenic: The context of the passage suggests that the variants E401G and S310F contribute to tumor development or progression by enhancing the phosphorylation of key HER family proteins involved in oncogenesis.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    12. Identification of potential dimerization partners of HER2 E401G protein

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 8

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the identification of potential dimerization partners of the HER2 E401G protein, indicating that the variant alters molecular interactions.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    13. Next, we analyzed C-terminal phosphorylation of HER2 using conventional SDS/PAGE and Western blotting. Compared with cells expressing ERBB2 WT, cells expressing ERBB2 S310F (a positive control variant elevating C-termina

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 7

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses how the variants S310F and E401G alter the C-terminal phosphorylation of HER2, indicating a change in molecular function.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    14. First, we examined whether E401G can form disulfide-linked dimers using SDS/PAGE under non-reducing conditions (for preserving disulfide bonds) and Western blotting. Compared with cells expressing ERBB2 WT, H460 cells ex

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 6

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the ability of the variants E321G, E401G, and S310F to form disulfide-linked dimers, indicating that these variants alter molecular function related to protein interactions.

      Gene→Variant (gene-first): 7157:E321G 2176:E401G 2064:S310F

      Genes: 7157 2176 2064

      Variants: E321G E401G S310F

    15. To examine the functional properties of ERBB2 E401G, an ECD III variant, we evaluated two types of mechanisms of activation of ECD variants previously reported: formation of disulfide-linked dimers and elevation of C-ter

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 5

      Evidence Type(s): Functional

      Justification: Functional: The passage mentions the evaluation of mechanisms for multiple ERBB2 variants, including E321G, E401G, S310F, and D845A, which suggests that these variants are being assessed for their biochemical functions.

      Gene→Variant (gene-first): 2064:D845A 7157:E321G 2176:E401G 2064:S310F

      Genes: 2064 7157 2176

      Variants: D845A E321G E401G S310F

    16. ERBB2 E401G has functional properties similar to those of S310F

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 4

      Evidence Type(s): Functional

      Justification: Functional: The passage indicates that ERBB2 E401G has functional properties similar to S310F, suggesting that these variants alter molecular or biochemical function.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    17. A 67-year-old Japanese woman, previous healthy, presented with right inguinal pain with no family history of cancer. Fluorodeoxyglucose (FDG)-positron emission tomography with CT showed increased FDG accumulation in the

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 3

      Evidence Type(s): Oncogenic, Functional

      Justification: Oncogenic: The passage describes the ERBB2 E401G variant as a somatic mutation that is associated with ERBB2 gene amplification, indicating its contribution to tumor development or progression. Functional: The passage mentions that multiple computational tools supported a deleterious effect of the ERBB2 E401G variant on the encoded gene product, suggesting that it alters molecular or biochemical function.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    18. Detection of ERBB2 E401G VUS in a patient with CUP

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 2

      Evidence Type(s): Diagnostic

      Justification: Diagnostic: The passage mentions the detection of the ERBB2 E401G variant of uncertain significance (VUS) in a patient, indicating its use in defining or classifying a disease context, specifically in a patient with cancer of unknown primary (CUP).

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    19. We found that ERBB2 E401G enhances C-terminal phosphorylation in a way similar to S310F. MD simulation analysis revealed that these variants maintain the stability of the EGFR-HER2 heterodimer in a ligand-independent man

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 6

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F alter molecular function by enhancing C-terminal phosphorylation and maintaining the stability of the EGFR-HER2 heterodimer. Oncogenic: The passage indicates that ERBB2 E401G-transduced cells exhibit increased tumor growth capacity in vivo, suggesting that this variant contributes to tumor development or progression.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    20. ERBB2 E401G was selected as VUS for analysis because multiple software tools predicted its pathogenicity. We prepared ERBB2 expression vectors with the E401G variant as well as vectors with S310F and E321G, which are kno

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 4

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses the evaluation of the phosphorylation of human epidermal growth factor receptor 2 and related proteins, as well as the investigation of the biological effects of the ERBB2 E401G variant, indicating an alteration in molecular function. Oncogenic: The mention of S310F and E321G as known activating mutations suggests that these variants contribute to tumor development or progression, aligning with the oncogenic evidence type.

      Gene→Variant (gene-first): 7157:E321G 2176:E401G 2064:S310F

      Genes: 7157 2176 2064

      Variants: E321G E401G S310F

    21. Dealing with variants of unknown significance (VUS) is an important issue in the clinical application of NGS-based cancer gene panel tests. We detected a novel ERBB2 extracellular domain VUS, c.1157A > G p.(E401G), in a

      [Paragraph-level] PMCID: PMC8881279 Section: ABSTRACT PassageIndex: 2

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the aim to clarify the biological functions of the ERBB2 E401G variant, indicating an interest in how this variant alters molecular or biochemical function.

      Gene→Variant (gene-first): 4609:1157A > G 2176:E401G

      Genes: 4609 2176

      Variants: 1157A > G E401G

    22. To examine tumor forming capacity in vivo, we constructed H460 cells that stably express ERBB2 (Fig. 8a) and assessed tumor growth after subcutaneous inoculation of these cells into mice. On the 21st day after transplant

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 17

      Evidence Type(s): Oncogenic

      Justification: Oncogenic: The passage discusses the tumor forming capacity of cells expressing the ERBB2 E401G variant, indicating that this somatic variant contributes to tumor development as evidenced by increased tumor growth in vivo.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    23. To examine the biologic effects of ERBB2 E401G in cancer cells, we evaluated the proliferative and invasive capacities of H460 cells. We found that cells expressing ERBB2 S310F exhibited a significantly higher proliferat

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 16

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses the effects of the ERBB2 E401G and S310F variants on the proliferative and invasive capacities of cancer cells, indicating that these variants alter molecular or biochemical functions related to cell behavior. Oncogenic: The evaluation of the proliferative and invasive capacities of cells expressing the ERBB2 variants suggests that these somatic variants contribute to tumor development or progression.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    24. Our simulation data showed that the activating mechanisms of ERBB2 E401G and S310F were related to the EGFR-HER2 heterodimer. The dimerization partner appears to be an important determinant of signaling activity. The two

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 14

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F alter the phosphorylation of downstream signaling pathway proteins, indicating a change in molecular function related to the MAPK pathway. Oncogenic: The evidence suggests that the variants contribute to tumor development or progression by activating signaling pathways associated with cancer, specifically through the ERBB2 dimerization and its effects on downstream signaling.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    25. In a previous simulation study, the dimer interfaces of both the EGFR homodimer and the EGFR-HER2 heterodimer were destabilized when the EGFR lost EGF (a specific ligand of EGFR). We therefore conducted MD simulations of

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 12

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses how the E401G and S310F mutations affect the dimer interface stability of the EGFR-HER2 complex, indicating that these variants alter molecular interactions and stability.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    26. To confirm whether HER2 homodimers or EGFR-HER2 heterodimers are more relevant to the mechanisms of ERBB2 E401G and S310F activation, we analyzed HER-family dimers using microsecond-timescale MD simulations. With regard

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 11

      Evidence Type(s): None

      Justification: Not enough information in this passage.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    27. HER2 p.(E401G) stabilizes ligand-free EGFR HER2 heterodimer

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 10

      Evidence Type(s): Functional

      Justification: Functional: The passage indicates that the variant p.(E401G) alters the stability of the ligand-free EGFR HER2 heterodimer, which suggests a change in molecular function.

      Gene→Variant (gene-first): 2176:p.(E401G)

      Genes: 2176

      Variants: p.(E401G)

    28. C-terminal phosphorylation of HER family proteins is caused by dimerization followed by trans-autophosphorylation, in which one receptor subunit of the dimer phosphorylates the other. Among the HER family proteins, EGFR,

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 9

      Evidence Type(s): Functional, Oncogenic

      Justification: Functional: The passage discusses how the variants E401G and S310F lead to increased phosphorylation levels of HER2 and EGFR, indicating that these variants alter molecular function related to protein activity. Oncogenic: The context of the passage suggests that the variants E401G and S310F contribute to tumor development or progression by enhancing the phosphorylation of key HER family proteins involved in oncogenesis.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    29. Identification of potential dimerization partners of HER2 E401G protein

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 8

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the identification of potential dimerization partners of the HER2 E401G protein, indicating that the variant alters molecular interactions.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    30. Next, we analyzed C-terminal phosphorylation of HER2 using conventional SDS/PAGE and Western blotting. Compared with cells expressing ERBB2 WT, cells expressing ERBB2 S310F (a positive control variant elevating C-termina

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 7

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses how the variants S310F and E401G alter the C-terminal phosphorylation of HER2, indicating a change in molecular function.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    31. First, we examined whether E401G can form disulfide-linked dimers using SDS/PAGE under non-reducing conditions (for preserving disulfide bonds) and Western blotting. Compared with cells expressing ERBB2 WT, H460 cells ex

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 6

      Evidence Type(s): Functional

      Justification: Functional: The passage discusses the ability of the variants E321G, E401G, and S310F to form disulfide-linked dimers, indicating that these variants alter molecular function related to protein interactions.

      Gene→Variant (gene-first): 7157:E321G 2176:E401G 2064:S310F

      Genes: 7157 2176 2064

      Variants: E321G E401G S310F

    32. To examine the functional properties of ERBB2 E401G, an ECD III variant, we evaluated two types of mechanisms of activation of ECD variants previously reported: formation of disulfide-linked dimers and elevation of C-ter

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 5

      Evidence Type(s): Functional

      Justification: Functional: The passage mentions the evaluation of mechanisms for multiple ERBB2 variants, including E321G, E401G, S310F, and D845A, which suggests that these variants are being assessed for their biochemical functions.

      Gene→Variant (gene-first): 2064:D845A 7157:E321G 2176:E401G 2064:S310F

      Genes: 2064 7157 2176

      Variants: D845A E321G E401G S310F

    33. ERBB2 E401G has functional properties similar to those of S310F

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 4

      Evidence Type(s): Functional

      Justification: Functional: The passage indicates that ERBB2 E401G has functional properties similar to S310F, suggesting that these variants alter molecular or biochemical function.

      Gene→Variant (gene-first): 2176:E401G 2064:S310F

      Genes: 2176 2064

      Variants: E401G S310F

    34. A 67-year-old Japanese woman, previous healthy, presented with right inguinal pain with no family history of cancer. Fluorodeoxyglucose (FDG)-positron emission tomography with CT showed increased FDG accumulation in the

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 3

      Evidence Type(s): Oncogenic, Functional

      Justification: Oncogenic: The passage describes the ERBB2 E401G variant as a somatic mutation that is associated with ERBB2 gene amplification, indicating its contribution to tumor development or progression. Functional: The passage mentions that multiple computational tools supported a deleterious effect of the ERBB2 E401G variant on the encoded gene product, suggesting that it alters molecular or biochemical function.

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G

    35. Detection of ERBB2 E401G VUS in a patient with CUP

      [Paragraph-level] PMCID: PMC8881279 Section: RESULTS PassageIndex: 2

      Evidence Type(s): Diagnostic

      Justification: Diagnostic: The passage mentions the detection of the ERBB2 E401G variant of uncertain significance (VUS) in a patient, indicating its use in defining or classifying a disease context, specifically in a patient with cancer of unknown primary (CUP).

      Gene→Variant (gene-first): 2176:E401G

      Genes: 2176

      Variants: E401G