1. Considerations for reporting variants in novel candidate genes identified during clinical genomic testing.
- Author
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Chong JX, Berger SI, Baxter S, Smith E, Xiao C, Calame DG, Hawley MH, Rivera-Munoz EA, DiTroia S, Bamshad MJ, and Rehm HL
- Subjects
- Humans, Exome genetics, Exome Sequencing methods, Genetic Predisposition to Disease, Genetic Variation, Genome, Human genetics, Genetic Testing methods, Genetic Testing standards, Genomics methods
- Abstract
Since the first novel gene discovery for a Mendelian condition was made via exome sequencing, the rapid increase in the number of genes known to underlie Mendelian conditions coupled with the adoption of exome (and more recently, genome) sequencing by diagnostic testing labs has changed the landscape of genomic testing for rare diseases. Specifically, many individuals suspected to have a Mendelian condition are now routinely offered clinical ES. This commonly results in a precise genetic diagnosis but frequently overlooks the identification of novel candidate genes. Such candidates are also less likely to be identified in the absence of large-scale gene discovery research programs. Accordingly, clinical laboratories have both the opportunity, and some might argue a responsibility, to contribute to novel gene discovery, which should, in turn, increase the diagnostic yield for many conditions. However, clinical diagnostic laboratories must necessarily balance priorities for throughput, turnaround time, cost efficiency, clinician preferences, and regulatory constraints and often do not have the infrastructure or resources to effectively participate in either clinical translational or basic genome science research efforts. For these and other reasons, many laboratories have historically refrained from broadly sharing potentially pathogenic variants in novel genes via networks such as Matchmaker Exchange, much less reporting such results to ordering providers. Efforts to report such results are further complicated by a lack of guidelines for clinical reporting and interpretation of variants in novel candidate genes. Nevertheless, there are myriad benefits for many stakeholders, including patients/families, clinicians, and researchers, if clinical laboratories systematically and routinely identify, share, and report novel candidate genes. To facilitate this change in practice, we developed criteria for triaging, sharing, and reporting novel candidate genes that are most likely to be promptly validated as underlying a Mendelian condition and translated to use in clinical settings., Competing Interests: Conflict of Interest All authors of this manuscript are funded by the NIH. Erica Smith is a current employee of Ambry Genetics and a stockholder of Invitae genetics. Megan H. Hawley is an employee of Invitae and own stock in the company. Michael J. Bamshad is the chair of the Scientific Advisory Board of GeneDx and receives funding from the American Society of Human Genetics as the Editor-in-Chief of HGG Advances. Jessica X. Chong receives funding from the American Society of Human Genetics as the Deputy Editor of HGG Advances. Heidi L. Rehm has received rare-disease research funding from Microsoft and Illumina and compensation as a past member of the scientific advisory board of Genome Medical., (Copyright © 2024 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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