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Common genetic variants associated with lung cancer have been well studied in the past decade. However, only 12.3% heritability has been explained by these variants. In this study, we investigate the contribution of rare variants (RVs) (minor allele frequency <0.01) to lung cancer through two large whole exome sequencing case-control studies. We first performed gene-based association tests using a novel Bayes Factor statistic in the International Lung Cancer Consortium, the discovery study (European, 1042 cases vs. 881 controls). The top genes identified are further assessed in the UK Biobank (European, 630 cases vs. 172 864 controls), the replication study. After controlling for the false discovery rate, we found two genes, CTSL and APOE, significantly associated with lung cancer in both studies. Single variant tests in UK Biobank identified 4 RVs (3 missense variants) in CTSL and 2 RVs (1 missense variant) in APOE stongly associated with lung cancer (OR between 2.0 and 139.0). The role of these genetic variants in the regulation of CTSL or APOE expression remains unclear. If such a role is established, this could have important therapeutic implications for lung cancer patients. Author summary: Lung cancer (LC) is the leading cause of cancer death accounting for 18% of all cancer deaths. Previous studies have suggested genetic contribution to the disease. Common genetic variants associated with LC have been well studied through large, collaborative, genome-wide association studies (GWASs) in the past decade. However, they explained only about 12.3% of LC heritability. It is therefore hypothesized that the unexplained variability might be partially due to rare variants (RVs). In this study, we applied a novel gene-based test statistic based on a Bayes Factor approach, to whole exome sequencing data from the International Lung Cancer consortium (ILCCO). Independent replication of the top genes identified was performed using the UK Biobank data. We found two genes, CTSL and APOE, significantly associated with LC in both studies. Within these two genes, several RVs showed strong associations with lung cancer in the UK Biobank data. These findings could suggest potential molecular mechanisms leading to lung cancer and more importantly, possible therapeutic targets for personalized treatment. [ABSTRACT FROM AUTHOR]

Genome-wide association studies (GWAS) have identified thousands of genetic variants that are associated with complex traits. However, a stringent significance threshold is required to identify robust genetic associations. Leveraging relevant auxiliary covariates has the potential to boost statistical power to exceed the significance threshold. Particularly, abundant pleiotropy and the non-random distribution of SNPs across various functional categories suggests that leveraging GWAS test statistics from related traits and/or functional genomic data may boost GWAS discovery. While type 1 error rate control has become standard in GWAS, control of the false discovery rate can be a more powerful approach. The conditional false discovery rate (cFDR) extends the standard FDR framework by conditioning on auxiliary data to call significant associations, but current implementations are restricted to auxiliary data satisfying specific parametric distributions, typically GWAS p-values for related traits. We relax these distributional assumptions, enabling an extension of the cFDR framework that supports auxiliary covariates from arbitrary continuous distributions ("Flexible cFDR"). Our method can be applied iteratively, thereby supporting multi-dimensional covariate data. Through simulations we show that Flexible cFDR increases sensitivity whilst controlling FDR after one or several iterations. We further demonstrate its practical potential through application to an asthma GWAS, leveraging various functional genomic data to find additional genetic associations for asthma, which we validate in the larger, independent, UK Biobank data resource. Author summary: Genome-wide association studies (GWAS) detect regions of the human genome that are associated with various traits, including complex diseases, but the power to detect these genomic regions is currently limited by sample size. The conditional false discovery rate (cFDR) provides a tool to leverage one GWAS study to improve power in another. The motivation is that if two traits have some genetic correlation, then our interpretation of a low but not significant p-value for the trait of interest will differ depending on whether that SNP shows strong or absent evidence of association with the related trait. Here, we describe an extension to the cFDR framework, called "Flexible cFDR", that controls the FDR and supports auxiliary data from arbitrary distributions, surpassing current implementations of cFDR which are restricted to leveraging GWAS p-values from related traits. In practice, our method can be used to iteratively leverage various types of functional genomic data with GWAS data to increase power for GWAS discovery. We describe the use of Flexible cFDR to supplement data from a GWAS of asthma with auxiliary data from functional genomic experiments. We identify associations novel to the original GWAS and validate these discoveries with reference to a larger, more highly-powered GWAS of asthma. [ABSTRACT FROM AUTHOR]