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Germline Missense Mutations in BTNL2 Increase Susceptibility to Prostate Cancer

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Key Points

  • Researchers studied multiple prostate cancer patients from families with a pattern of hereditary prostate cancer and found that two rare germline missense variants in BTNL2 were most strongly related to the development of prostate cancer.
  • Men who carried one of these variants had a significant 2.5- to 2.7-fold higher risk for developing prostate cancer compared to men who did not carry either mutation.

A team of researchers led by Janet Stanford, PhD, of Fred Hutchinson Cancer Research Center has discovered that mutations in the gene BTNL2, which encodes a protein involved in regulating T-cell proliferation and cytokine production—both of which impact immune function—increase the risk of developing prostate cancer.

The findings, by Dr. Stanford and colleagues from the University of Washington Genome Sciences Department and the National Human Genome Research Institute, were published online in Cancer Epidemiology, Biomarkers & Prevention.

Strong Genetic Component to Prostate Cancer

Prostate cancer is a complex disease and its causes include a strong genetic component. It is estimated that about 42% of prostate cancer cases are due to heritable factors, and 5% to 10% of those prostate cancer cases are thought to result from rare inherited mutations.

The researchers studied multiple prostate cancer patients from families with a pattern of hereditary prostate cancer. Germline DNA provided by patients with more aggressive or early-onset disease was sequenced in an attempt to identify rare genetic mutations that predispose to prostate cancer. All the participants were men of European ancestry.

Several genes with candidate mutations were highlighted, but two coding variants in the butyrophilin-like 2 (BTNL2) gene were most strongly related to the development of prostate cancer. These germline missense mutations were subsequently confirmed to be clearly associated with prostate cancer in an independent set of families with hereditary prostate cancer and in a case-control study population.

The team found that the two BTNL2 mutations associated with elevated prostate cancer risk are rare. In the 270 hereditary prostate cancer families used for confirmation, about 1.5% of affected men carried one of the mutations but unaffected men carried none. In the population-based case-control study, 2% of prostate cancer cases and less than 1% of men without prostate cancer carried one of the variants.

Increased Risk of Both Hereditary and Sporadic Cancer

In the case-control study, men who carried one of these variants had a significant 2.5- to 2.7-fold higher risk for developing prostate cancer compared to men who did not carry either mutation.

“This research demonstrates for the first time that rare mutations in the BTNL2 gene enhance susceptibility to both hereditary and sporadic prostate cancer,” said Dr. Stanford, Co-Director of the Program in Prostate Cancer Research and a member of the Public Health Sciences Division at Fred Hutchinson. Common variants in this gene have been previously linked to several autoimmune and inflammatory diseases such as sarcoidosis and ulcerative colitis.

The researchers used whole-exome sequencing to identify genetic variations within 91 men from 19 hereditary prostate cancer families. They then evaluated 130 candidate mutations that were observed more frequently in the men with prostate cancer in an independent set of 270 hereditary prostate cancer families for further confirmation.

Other candidate mutations found in this whole-exome sequencing study will be evaluated in a future investigation involving a larger group of hereditary prostate cancer families and case-control populations to further assess their link to prostate cancer.

The research was funded by the National Cancer Institute, Fred Hutchinson Cancer Research Center, and the Prostate Cancer Foundation.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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