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Variant interpretation report

NF2 c.778G>T, p.(Glu260Ter)

NM_000268.3:c.778G>T NP_000259.1:p.(Glu260Ter) Nonsense · exon 8 View identifiers
Classification
Uncertain significance

Variant description:

No variant summary was recorded for this case.

Five-step scale from benign to pathogenic. This variant is uncertain. Select a step to read what it means.

Uncertain.The recorded classification is uncertain significance.

In plain language

Gene-level background from the recorded interpretation.

About NF2

NF2 encodes Merlin, a scaffolding protein that links the cell's internal skeleton to the cell membrane and helps regulate cell growth, adhesion, and signaling. Loss of its function promotes tumor formation and spread. Germline mutations in this gene cause neurofibromatosis type 2, an inherited condition marked by tumors of the nervous system and skin, along with eye abnormalities. It acts as a tumor suppressor, and the gene is also found mutated in other types of cancer.

LYFE Sciences is an AI system, and it can make mistakes. Criteria may be applied incorrectly, sources may be misread, and a confident-looking classification can still be wrong. Double-check every criterion and its underlying evidence before relying on any call.
01The reasoning

How it was classified

The recorded framework is Not recorded. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.

Recorded applied criteria

The applied criteria and their strengths are shown as assessed under the stated framework.

Pathogenic evidence criteria: 2 Benign evidence criteria: 1
Pathogenic criteria applied · 2
PVS1Very strong
PVS1 · very strong

Met (Very Strong): the nonsense variant p.(Glu260Ter) is predicted to trigger nonsense-mediated decay, consistent with a null NF2 allele.

PM2Supporting
PM2 · supporting

Met (Supporting): absent from gnomAD v2.1, v4.1, and gnomAD-Canada population databases.

Benign criteria applied · 1
BP4Supporting
BP4 · supporting

Met (Supporting): SpliceAI max delta 0.149 is below the ~0.2 cutoff, predicting no significant splice disruption.

Recorded classification: Uncertain significance

VUS: conflicting evidence - PVS1 (very strong) and PM2 (supporting) for pathogenicity versus BP4 (supporting) against it - left the classification unresolved under the generic ACMG/AMP 2015 rules.

02The sources

Evidence at a glance

Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.

SpliceAI score
0.149 maximum delta

Recorded SpliceAI maximum delta score: 0.149. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
Not recorded

A ClinVar laboratory submission summary was not recorded.

Context only ClinVar ↗
Functional evidence
Statement recorded

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Likely Loss-of-function; curated oncogenicity label: Likely Oncogenic.

No listed criterion applied OncoKB ↗
COSMIC
Cancer Hotspots
Somatic evidence
No matching record reported

This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.

For specialists

Technical detail

ACMG/AMP criteria under Not recorded, with the data and sources behind each one.

28 criteria with recorded statuses: 3 met · 3 not met · 13 not assessed · 9 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

PVS1 applied at full (Very Strong) strength using the generic ClinGen SVI PVS1 decision tree because no NF2-specific VCEP PVS1 specification was found for this case.

The variant is a nonsense change predicted to undergo NMD, truncating merlin by more than half its length, in an internal exon with no evidence of LoF tolerance or alternative splicing rescue, satisfying the top-tier generic PVS1 pathway for null variants.

This variant (NM_000268.3:c.778G>T, p.(Glu260Ter)) is a nonsense/truncating change; the case bundle contains no CSPEC/VCEP framework for NF2 and no variant-specific functional assay literature. The four retrieved PMIDs are general NF2 clinical reviews and genotype-phenotype correlation studies of truncating mutations as a class, not variant-specific functional assays, so neither PS3 nor BS3 can be applied and both are returned as not_assessed.

No governing VCEP/gene-specific PP3/BP4 lookup material exists for NF2 in this case (cspec not found, vcep_materials empty), so generic ACMG in-silico rules were applied.

Variant is a nonsense/stop-gain change (p.(Glu260Ter)); missense predictors (REVEL, BayesDel) are the wrong primary mechanism-fit and, independently, REVEL is unavailable (null) and BayesDel is not calibrated in this pipeline (no verified published threshold), so the missense in-silico path could not support either PP3 or BP4.

The splice-impact path (SpliceAI) shows a low max delta score of 0.149, below the ~0.2 cutoff generally used to flag likely splice disruption, supporting BP4 at supporting strength and precluding PP3.

BP7 (synonymous) does not apply; the variant is a nonsense substitution, not synonymous.

No NF2-specific ClinGen/VCEP framework was available in the case bundle, so generic ACMG/AMP population rules were used.

The population evidence is absence-only: it supports PM2, while it does not support BA1, BS1, or BS2.

Met · 3

PVS1 Very strongMet (Very Strong): the nonsense variant p.(Glu260Ter) is predicted to trigger nonsense-mediated decay, consistent with a null NF2 allele. Details ▾Hide ▴
Reasoning

No NF2-specific ClinGen VCEP PVS1 specification is available for this case (cspec.found=false, gene_vcep_dir=null), so the generic ACMG/AMP PVS1 decision tree (ClinGen SVI recommendations, PMC6185798) was applied. NM_000268.3:c.778G>T produces NP_000259.1:p.(Glu260Ter), a nonsense variant in the NF2 transcript (consequence_class='nonsense'). Gene-level LoF mechanism was confirmed eligible for germline NF2 disease (pvs1_gene_context: lof_mechanism_supported=true, pvs1_gene_gate='eligible'), consistent with NF2-related schwannomatosis arising from biallelic/functional loss of merlin. Transcript relevance: NM_000268.3 is the reference/CCDS-linked transcript (CCDS13861.1) used for annotation, and the stop is predicted from the canonical CDS (c.1-1788, 596 aa protein). NMD prediction: exon boundaries from the transcript model place c.778 within an internal coding exon (c.676-810, well upstream of the terminal exon-exon junction at approximately c.1737/1738), i.e. more than 50 nt upstream of the last exon-exon junction, so the premature termination codon is predicted to trigger nonsense-mediated decay, consistent with a null allele. Protein length change: even absent NMD, the truncation would remove residues 260-596 (337 of 596 aa, ~57% of the protein), eliminating the C-terminal FERM-associated/tail region required for merlin function -- a substantial truncation, not a distal/non-critical loss. Exon importance/repeat-region context: exon 8 (c.676-810) is a constitutively included internal coding exon with no evidence in the gathered materials of being alternatively spliced, minimally conserved, or enriched for benign population-observed LoF variation; the variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada, arguing against this exon tolerating LoF variation in the general population. SpliceAI predicts no meaningful splice disruption (max delta 0.149, below typical actionable thresholds), so this is assessed purely as a canonical nonsense/NMD-predicted LoF variant, not a splice-altering event, avoiding double counting with splice-based evidence. No exon-skipping rescue or reinitiation evidence was identified. Taken together, this meets the ClinGen SVI generic PVS1 criteria at full (Very Strong) strength for NF2.

Rule
PVS1_generic_ClinGen_SVI_PMC6185798
Evidence considered
  • case_summary.json cspec.found=false and vcep_materials.final_classification_framework.found=false confirm no NF2-specific VCEP PVS1 specification is available, mandating generic ACMG/AMP PVS1 fallback per PMC6185798 (pvs1_variant_assessment.framework_source).
  • pvs1_gene_context.json: lof_mechanism_supported=true and pvs1_gene_gate='eligible', with mechanism_rationale stating that targeted germline literature review identified disease-focused publications supporting NF2 loss of function as a germline disease mechanism.
  • pvs1_variant_assessment.json: consequence_class='nonsense', variant_bucket='nonsense', protein_1l='NP_000259.1:p.(E260*)', suggested_default_strength='PVS1', with rationale that nonsense variants are evaluated with the generic PVS1 framework once germline LOF is established.
  • prefetch.json mutalyzer selector_short exon/CDS coordinate table shows c.778 falls in the exon spanning c.676-810 (an internal exon), and the CDS terminal exon-exon junction is at approximately c.1737/1738, placing the premature stop far (>50 nt) upstream of the last junction, consistent with NMD.
  • prefetch.json mutalyzer protein prediction: predicted truncated protein 'MAGAIASRMSFSSLKRKQPKTFTVRIVTMDAEMEFNCEMKWKGKDLFDLVCRTLGLRETWFFGLQYTIKDTVAWLKMDKKVLDHDVSKEEPVTFHFLAKFYPENAEEELVQEITQHLFFLQVKKQILDEKIYCPPEASVLLASYAVQAKYGDYDPSVHKRGFLAQEELLPKRVINLYQMTPEMWEERITAWYAEHRGRARDEAEMEYLKIAQDLEMYGVNYFAIRNKKGTELLLGVDALGLHIYDPENRLTPKISFPWN*' ends at position 260 versus wild-type length 596 (position_last_original=596, position_last_predicted=260), confirming loss of 337 residues (~57% of the protein).
  • case_summary.json compact_evidence.spliceai: SpliceAI max delta score 0.149 (DS_AL=0.149, all other deltas <=0.035), interpreted as no significant splice impact, so this variant is treated as a straightforward nonsense/NMD event rather than a splice-disruption event, avoiding evidence overlap with splice-based criteria.
  • case_summary.json compact_evidence.gnomad: variant absent from gnomAD v2.1, v4.1, and gnomAD-Canada v1.0, providing no population evidence that this exon or codon position tolerates LoF variation.
Still missing
  • No NF2/schwannomatosis-specific ClinGen VCEP PVS1 specification exists yet for this case; assessment relies on the generic ClinGen SVI PVS1 decision tree (PMC6185798).
  • Exact exon number and precise last-exon-junction distance were derived from transcript coordinate ranges in the prefetch normalization data rather than a curated NF2 exon map; no evidence was found that exon 8 is a recognized non-critical or LoF-tolerant region.
  • No direct experimental NMD confirmation (e.g., patient RNA/transcript-level study) for this specific variant was located; NMD status is a rule-based prediction from position relative to the terminal exon junction.
Sources
pvs1_generic_framework ↗pvs1_gene_contextpvs1_variant_assessment
PM2 SupportingMet (Supporting): absent from gnomAD v2.1, v4.1, and gnomAD-Canada population databases. Details ▾Hide ▴
Reasoning

PM2 is met at supporting strength under the generic ACMG/AMP fallback. NM_000268.3:c.778G>T (p.Glu260Ter) is reported absent from gnomAD v2.1, gnomAD v4.1, and gnomAD-Canada v1.0. The bundle does not provide dataset-specific allele-number or coverage metrics, so confidence is moderated and the conclusion is limited to absence in the queried datasets.

Rule
Generic ACMG/AMP PM2: absence or extremely low frequency in population databases appropriate to the disease prevalence and inheritance model supports PM2; apply at supporting strength here.
Evidence considered
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD v2.1.
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD v4.1.
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD-Canada v1.0.
  • The absence is concordant across the available population datasets, but the bundle does not expose per-dataset allele-number or coverage metrics.
Still missing
  • The queried population records contain no allele-number, coverage, or gene-level constraint details for this position.
Sources
BP4 SupportingMet (Supporting): SpliceAI max delta 0.149 is below the ~0.2 cutoff, predicting no significant splice disruption. Details ▾Hide ▴
Reasoning

SpliceAI predicts no significant splice impact for NM_000268.3:c.778G>T, with a max delta score of 0.149 (DS_AG 0.0, DS_AL 0.149, DS_DG 0.006, DS_DL 0.035), below the ~0.2 delta-score cutoff commonly used (per the original SpliceAI validation publication) to flag a likely splicing effect. No NF2-specific VCEP PP3/BP4 lookup material is available, so this generic threshold is applied. This supports BP4 at supporting strength on the splice-impact path. The missense in-silico path (REVEL/BayesDel) is not usable to independently support or refute BP4: REVEL is not available (null) and BayesDel's 0.66 score cannot be applied because no verified published calibration threshold for BayesDel is available to this pipeline.

Rule
Generic ACMG BP4 (SpliceAI max delta score < ~0.2, based on original SpliceAI calibration thresholds), applied supporting strength; no gene-specific VCEP override present.
Evidence considered
  • SpliceAI evidence_sentence: 'SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15).' Scores: DS_AG=0.0, DS_AL=0.149, DS_DG=0.006, DS_DL=0.035; max_delta_score=0.149, below the ~0.2 SpliceAI delta-score threshold associated with likely splice-altering effects.
  • BayesDel score 0.66 (local BayesDel_170824_noAF lookup) not used because no verified published calibration threshold/PMID for BayesDel is available to this pipeline.
  • REVEL not available for this position (revel_score null).
Still missing
  • No gene-specific (NF2) VCEP-endorsed SpliceAI threshold was available; a generic ~0.2 cutoff was applied in the absence of a governing framework.
  • BayesDel score (0.66) could not be used because no verified published threshold is available to this pipeline for that predictor.
Sources

Not met · 3 · evaluated, threshold not reached

PP3 Not met: SpliceAI max delta 0.149 is below the ~0.2 cutoff for a likely splice-altering effect. Details ▾Hide ▴
Reasoning

This variant (NM_000268.3:c.778G>T, p.(Glu260Ter)) is a nonsense/stop-gain substitution. No governing VCEP or gene-specific PP3/BP4 lookup material is available for NF2 (cspec not found; vcep_materials empty), so generic ACMG in-silico evidence rules apply. On the missense in-silico path, REVEL was not computed for this variant (revel_score = null) and BayesDel returned a score (0.66) but this pipeline has no verified published threshold/table for BayesDel, so it must be treated as not_available for calibrated PP3/BP4 use regardless of the numeric value. On the splice-impact path, SpliceAI returned a max delta score of 0.149 (DS_AG 0.0, DS_AL 0.149, DS_DG 0.006, DS_DL 0.035), which falls below the ~0.2 delta-score cutoff established in the original SpliceAI validation study for flagging a likely splice-altering effect. No computational evidence therefore reaches the threshold needed to support a deleterious/splice-disrupting effect, so PP3 is not met.

Rule
Generic ACMG PP3 (SpliceAI max delta score threshold ~0.2 from Jaganathan et al. 2019 original SpliceAI calibration); missense predictors excluded as not_available (REVEL null, BayesDel uncalibrated in this pipeline).
Evidence considered
  • SpliceAI evidence_sentence: 'SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15).' Scores: DS_AG=0.0, DS_AL=0.149, DS_DG=0.006, DS_DL=0.035; max_delta_score=0.149.
  • BayesDel score 0.66 found via local BayesDel_170824_noAF lookup, but per pipeline calibration policy no verified published threshold/PMID is available for BayesDel, so it is treated as not_available for PP3/BP4 and was not used to support this determination.
  • REVEL lookup returned found=false, revel_score=null for this position; no REVEL evidence available.
Still missing
  • No gene-specific (NF2) VCEP PP3/BP4 lookup table or calibrated threshold spreadsheet was found for this case.
  • REVEL score not available for this position (revel_score null in prefetch/evidence data).
  • BayesDel score exists (0.66) but no verified published calibration threshold is available to this pipeline, so it cannot be used to support or refute PP3 for this variant.
Sources
BA1 Not met: the variant is absent from population databases, so no allele frequency reaches the standalone benign threshold. Details ▾Hide ▴
Reasoning

BA1 is not met. The variant is absent from gnomAD v2.1, gnomAD v4.1, and gnomAD-Canada v1.0; therefore no population allele frequency at or above the standalone benign threshold is documented.

Rule
Generic ACMG/AMP BA1: a population allele frequency high enough to stand alone as benign is required; no such frequency is present.
Evidence considered
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD v2.1.
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD v4.1.
  • The case bundle reports NM_000268.3:c.778G>T as absent from gnomAD-Canada v1.0.
Sources
BS1 Not met: the variant is absent from population datasets, so no allele frequency exceeds the expected rate for NF2-related disease. Details ▾Hide ▴
Reasoning

BS1 is not met. The variant is absent from the available population datasets, so there is no allele frequency greater than expected for NF2-related disease.

Rule
Generic ACMG/AMP BS1: a population frequency greater than expected for the disorder is required; the available observations do not show this.
Evidence considered
  • The case bundle reports no observed allele for NM_000268.3:c.778G>T in gnomAD v2.1, gnomAD v4.1, or gnomAD-Canada v1.0.
  • Because the variant is not observed, no frequency excess relative to the expected NF2 disease prevalence, penetrance, or inheritance model can be demonstrated.
Sources

Not assessed · 13 · no assessment recorded

PS2 Not assessed: no confirmed de novo occurrence is documented; parental testing and phenotype information were not available. Details ▾Hide ▴
Reasoning

No confirmed de novo observation is documented for NM_000268.3:c.778G>T. The case-evidence bundle contains no proband phenotype assessment, parental genotypes, confirmed maternity and paternity, or other de novo testing details. PS2 cannot be applied without documented parental testing and a phenotype consistent with NF2-related disease.

Rule
PS2 requires a confirmed de novo occurrence in the patient with confirmed maternity and paternity; phenotype consistency and reliable variant testing should be documented before applying the criterion.
Evidence considered
  • No NF2-specific ClinGen VCEP or gene-specific framework was retrieved; generic ACMG/AMP fallback was therefore used.
  • The consolidated case-evidence bundle provides no variant-specific proband, parental-testing, phenotype, or de novo evidence.
Still missing
  • Proband phenotype and diagnostic features consistent with NF2-related schwannomatosis
  • Variant testing results for both biological parents
  • Confirmed maternity and paternity and evidence excluding parental mosaicism where relevant
  • Laboratory or case report documentation establishing the variant as de novo
Sources
generic_acmg_combination_rules
PS3 Not assessed: no validated functional assay specific to this variant was available. Details ▾Hide ▴
Reasoning

No ClinGen VCEP/CSPEC framework is available for NF2 (cspec.found=false), so generic ACMG PS3 requirements apply: a validated functional assay demonstrating damaging effect, with appropriate controls, specific to this variant (NM_000268.3:c.778G>T, p.(Glu260Ter)). The four literature-packet PMIDs retrieved (19545378, 22825583, 8755919, 9643284) are all general NF2 clinical/molecular reviews or genotype-phenotype correlation studies of truncating mutations as a class; none report a variant-specific functional/biochemical assay (e.g., merlin protein activity, growth suppression, Hippo pathway signaling) for c.778G>T/p.E260*, and none of the variant's exact HGVS designations appear in the retrieved abstract snippets. No functional assay evidence for this specific variant was found in the bundle.

Still missing
  • No variant-specific functional assay (e.g., merlin/Hippo pathway functional study) identified for NM_000268.3:c.778G>T / p.(Glu260Ter)
  • No CSPEC/VCEP functional assay framework available for NF2 to define assay validation thresholds
PS4 Not assessed: no affected-case counts, controls, or variant-specific case series were available. Details ▾Hide ▴
Reasoning

PS4 cannot be assessed because the case bundle contains no affected-case count, control count, case-control enrichment statistic, or variant-specific case series for NM_000268.3:c.778G>T. The available literature describes NF2 cohorts and genotype-phenotype correlations but does not report this exact variant and cannot substitute for variant-specific case-control evidence.

Rule
Generic ACMG/AMP fallback applies because no NF2-specific VCEP/CSPEC framework was retrieved. PS4 requires statistically significant enrichment of the exact variant in affected individuals compared with controls, or a qualifying variant-specific case series under an applicable specification.
Evidence considered
  • The case bundle records no exact ClinVar record, no variant-specific case count, and no case-control dataset for NM_000268.3:c.778G>T.
  • PMID:9643284 reports a cohort of NF2 families and genotype-phenotype correlations, but its listed nonsense variant at c.784C>T (p.Arg262Ter) is not the exact submitted variant c.778G>T (p.Glu260Ter); therefore it does not establish PS4 for this variant.
Still missing
  • Variant-specific affected-case and control counts or a statistically supported case-control enrichment analysis are unavailable.
  • No exact-variant case series with independently documented NF2 diagnoses is available in the bundle.
Sources
PM6 Not assessed: no parental testing or case-level information supporting a de novo occurrence was available. Details ▾Hide ▴
Reasoning

No assumed or suspected de novo occurrence is documented for NM_000268.3:c.778G>T. The case-evidence bundle contains no parental testing, maternity or paternity information, proband phenotype, or case-level observation supporting PM6. PM6 cannot be applied from the absence of family information or from generic NF2 literature.

Rule
PM6 may support an assumed de novo occurrence when maternity and paternity are not confirmed, but a documented case observation and compatible phenotype are still required; absence of family data is insufficient.
Evidence considered
  • No NF2-specific ClinGen VCEP or gene-specific framework was retrieved; generic ACMG/AMP fallback was therefore used.
  • The consolidated case-evidence bundle provides no variant-specific presumed-de-novo, parental, or phenotype evidence.
Still missing
  • A documented de novo or presumed-de-novo case observation for the exact variant
  • Parental relationship and testing information, even if one or both parents were not fully genotyped
  • Proband phenotype consistent with NF2-related disease
Sources
generic_acmg_combination_rules
PP1 Not assessed: no family segregation data or informative meioses were available. Details ▾Hide ▴
Reasoning

No informative segregation is documented for NM_000268.3:c.778G>T. The case-evidence bundle contains no affected relatives, family genotypes, phenotype-segregation observations, or countable meioses. PP1 cannot be assigned at any strength.

Rule
PP1 supports co-segregation of the variant with disease in affected family members; strength requires an informative number of affected relatives and meioses, with phenotype and penetrance considered.
Evidence considered
  • No NF2-specific ClinGen VCEP or gene-specific segregation rule was retrieved; generic ACMG/AMP fallback was therefore used.
  • The consolidated case-evidence bundle provides no variant-specific affected-relative, family-genotype, phenotype-segregation, or meiosis data.
Still missing
  • Affected relatives with phenotype consistent with NF2-related disease
  • Confirmed genotypes for the variant in affected relatives
  • Family structure and informative meioses sufficient to quantify segregation
  • Documentation addressing age-related penetrance and whether apparently unaffected relatives are informative
Sources
generic_acmg_combination_rules
PP4 Not assessed: no patient phenotype or clinical diagnostic criteria were available to evaluate phenotype specificity. Details ▾Hide ▴
Reasoning

PP4 cannot be assessed because the case bundle provides no individual phenotype, clinical diagnostic criteria, or feature list for the patient carrying NM_000268.3:c.778G>T. General descriptions of NF2 phenotype specificity do not establish that this patient's phenotype is highly specific for NF2.

Rule
Generic ACMG/AMP fallback applies because no NF2-specific VCEP/CSPEC framework was retrieved. PP4 requires a patient's phenotype or highly specific clinical findings to be highly specific for the disease or phenotype associated with the gene; gene-level phenotype descriptions alone are insufficient.
Evidence considered
  • The case bundle contains no patient-level clinical findings, family history, tumor findings, or NF2 diagnostic criteria assessment.
  • PMID:19545378 and PMID:9643284 describe NF2 as involving characteristic schwannomas, meningiomas, and vestibular schwannomas, but general disease descriptions cannot be applied to an undocumented patient phenotype.
Still missing
  • Patient phenotype and clinical diagnostic information are absent.
  • No documentation is available showing that the patient's findings meet established NF2 diagnostic criteria or are highly specific for NF2.
Sources
PP5 Not assessed: no ClinVar expert-panel pathogenic classification is documented for this exact variant. Details ▾Hide ▴
Reasoning

PP5 is not assessable because the exact variant NM_000268.3:c.778G>T is absent from the retrieved ClinVar record and no ClinVar expert-panel Pathogenic or Likely pathogenic classification is documented. OncoKB's variant-specific label is not a ClinVar expert-panel assertion and cannot trigger PP5.

Rule
PP5 may be applied only when an exact-variant ClinVar expert panel asserts Pathogenic or Likely pathogenic. Ordinary laboratory submissions, aggregate ClinVar labels, non-expert assertions, and non-ClinVar databases do not qualify.
Evidence considered
  • The ClinVar search in the case bundle returned no exact match for NM_000268.3:c.778G>T and recorded the variant as absent from ClinVar.
  • OncoKB reported a variant-specific Likely Oncogenic label, but this is not an exact-variant ClinVar expert-panel assertion and is excluded from PP5 by the governing instruction.
Still missing
  • No exact-variant ClinVar expert-panel Pathogenic or Likely pathogenic classification is available.
  • The exact variant has no retrieved ClinVar record.
Sources
BS2 Not assessed: no healthy-adult cohort or unaffected-control observation of this variant was available. Details ▾Hide ▴
Reasoning

BS2 cannot be assessed from the case bundle. No healthy-adult cohort, unaffected homozygote observation, or phenotype-confirmed control observation for this variant is provided. Absence from population databases is not itself evidence that the variant occurs in healthy adults.

Rule
Generic ACMG/AMP BS2: observation in healthy adults, especially homozygotes for a dominant disorder, is required; no qualifying observation is available.
Still missing
  • No documented observation of the variant in healthy adults or unaffected homozygous individuals.
  • No age, phenotype, zygosity, or penetrance information for any putative unaffected carrier is available.
BS3 Not assessed: no functional assay evidence of a benign effect for this specific variant was available. Details ▾Hide ▴
Reasoning

No ClinGen VCEP/CSPEC framework is available for NF2 (cspec.found=false). Generic ACMG BS3 requires a validated functional assay showing no damaging effect, specific to this variant. The retrieved literature packet contains only general NF2 clinical/molecular reviews and genotype-phenotype correlation studies of truncating variants as a class (PMID:19545378, PMID:22825583, PMID:8755919, PMID:9643284); none describe a functional assay result, variant-specific or otherwise, for c.778G>T/p.E260*. No functional assay evidence of a benign/neutral effect for this specific variant was found in the bundle.

Still missing
  • No variant-specific functional assay data (of any direction) identified for NM_000268.3:c.778G>T / p.(Glu260Ter)
  • No CSPEC/VCEP functional assay framework available for NF2
BS4 Not assessed: no unaffected relatives with reliable genotypes were available to demonstrate lack of segregation. Details ▾Hide ▴
Reasoning

No informative lack of segregation is documented for NM_000268.3:c.778G>T. The case-evidence bundle contains no unaffected relatives with reliable genotype data, no family phenotype assessments, and no information establishing that any non-carrier is sufficiently old and clinically evaluated to be informative. BS4 cannot be applied.

Rule
BS4 requires reliable lack of segregation in informative unaffected relatives; age, penetrance, phenotype assessment, and family structure must be adequate before assigning benign weight.
Evidence considered
  • No NF2-specific ClinGen VCEP or gene-specific rule was retrieved; generic ACMG/AMP fallback was therefore used.
  • The consolidated case-evidence bundle provides no variant-specific unaffected-relative, non-segregation, genotype, phenotype, or meiosis data.
Still missing
  • Unaffected relatives with confirmed genotypes showing the variant is absent or does not track with disease
  • Reliable clinical phenotyping and age-appropriate evaluation of those relatives
  • Family structure, penetrance context, and informative meioses
  • Exclusion of phenocopies, reduced penetrance, and inadequate follow-up
Sources
generic_acmg_combination_rules
BP2 Not assessed: no second variant or phase information was available to evaluate trans configuration. Details ▾Hide ▴
Reasoning

BP2 cannot be assessed from the available evidence. For a dominant disorder, BP2 requires observation of the variant in trans with a pathogenic variant, with appropriate phase and clinical context. The case bundle provides no second variant in the individual and no cis/trans or affected-proband phase observations for NM_000268.3:c.778G>T.

Rule
Generic ACMG/AMP BP2 may support a benign interpretation when a variant is observed in trans with a pathogenic variant in a fully penetrant dominant disorder; phase and the relevant allelic observation must be documented.
Evidence considered
  • The consolidated case-evidence bundle contains no affected-proband allelic observations, second pathogenic variant, segregation result, or cis/trans phase information for NM_000268.3:c.778G>T.
  • The available NF2 literature reviewed for this case concerns disease phenotype and mutation classes rather than the exact case variant's allelic phase; it cannot establish BP2.
Still missing
  • A documented second pathogenic or likely pathogenic variant in the same individual is needed.
  • Reliable cis/trans phase information and the individual's phenotype/inheritance context are needed to evaluate BP2.
BP5 Not assessed: no evidence that the phenotype is explained by an alternative molecular cause was available. Details ▾Hide ▴
Reasoning

BP5 cannot be assessed because the case bundle contains no evidence that the patient's phenotype is explained by an alternative molecular cause or an alternative pathogenic variant. The absence of such evidence is not sufficient to apply BP5.

Rule
Generic ACMG/AMP fallback applies because no NF2-specific VCEP/CSPEC framework was retrieved. BP5 requires a well-supported alternative molecular cause that explains the patient's phenotype; it must not be inferred from missing information or from the variant's absence in databases.
Evidence considered
  • The case bundle does not provide a competing pathogenic variant, alternative molecular diagnosis, or clinical evidence establishing an alternate explanation for the phenotype.
Still missing
  • No alternative molecular diagnosis or pathogenic variant is documented for the case.
  • No evidence links an alternative cause to the reported phenotype.
BP6 Not assessed: no ClinVar expert-panel benign classification is documented for this exact variant. Details ▾Hide ▴
Reasoning

BP6 is not assessable because the exact variant NM_000268.3:c.778G>T is absent from the retrieved ClinVar record and no ClinVar expert-panel Benign or Likely benign classification is documented. No ordinary laboratory submission, aggregate label, or non-expert assertion may trigger BP6.

Rule
BP6 may be applied only when an exact-variant ClinVar expert panel asserts Benign or Likely benign. Ordinary laboratory submissions, aggregate ClinVar labels, non-expert assertions, and non-ClinVar databases do not qualify.
Evidence considered
  • The ClinVar search in the case bundle returned no exact match for NM_000268.3:c.778G>T and recorded the variant as absent from ClinVar.
  • No qualifying expert-panel Benign or Likely benign assertion is present; therefore BP6 cannot be applied.
Still missing
  • No exact-variant ClinVar expert-panel Benign or Likely benign classification is available.
  • The exact variant has no retrieved ClinVar record.
Sources
Not applicable · 9· recorded as not applicable Show reasons ▾Hide reasons ▴
PS1 N/ANot applicable: as a nonsense variant, no altered amino acid exists at this position to compare against previously established pathogenic variants. Details ▾Hide ▴
Reasoning

PS1 (Richards et al. 2015, PMID:25741868) requires the same amino acid change as a previously established pathogenic variant, evaluated regardless of the underlying nucleotide change. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, no altered amino acid exists at this position to compare against any previously established pathogenic missense variant, so PS1's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
PM1 N/ANot applicable: as a nonsense variant, no altered residue exists to evaluate for mutational hot-spot or critical-domain membership. Details ▾Hide ▴
Reasoning

PM1 (Richards et al. 2015, PMID:25741868) applies to a missense variant located in a mutational hot spot and/or a critical, well-established functional domain without benign variation. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, no altered residue exists to evaluate for mutational hot-spot or critical-domain membership, so PM1's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
PM3 N/ANot applicable: NF2-related schwannomatosis is autosomal dominant, so the recessive trans-phase criterion does not apply. Details ▾Hide ▴
Reasoning

PM3 is not applicable because NF2-related schwannomatosis is described in the case evidence as an autosomal-dominant disorder; PM3 is intended for pathogenic variants observed in trans in affected individuals with a recessive disorder. The case bundle contains no recessive inheritance framework or affected-proband trans-phase observations that would make PM3 applicable.

Rule
Generic ACMG/AMP PM3 is not applicable to an autosomal-dominant NF2 disorder; PM3 requires affected individuals with pathogenic variants in trans in a recessive disease context.
Evidence considered
  • The case bundle reports no applicable NF2-specific VCEP/CSPEC framework and uses generic ACMG fallback.
  • The reviewed NF2 clinical review describes NF2 as a dominantly inherited tumour-prone disorder; it does not provide PM3-style recessive trans-phase evidence for NM_000268.3:c.778G>T.
  • No affected proband observations, second pathogenic allele, or phase information relevant to PM3 are present in the consolidated case-evidence bundle.
Sources
PM4 N/ANot applicable: as a nonsense variant, no protein length change occurs, leaving nothing for this length-change criterion to evaluate. Details ▾Hide ▴
Reasoning

PM4 (Richards et al. 2015, PMID:25741868) applies to protein length changes: in-frame insertions/deletions in a non-repetitive region, or stop-loss variants that extend the protein past the reference stop codon. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, no change in protein length occurs, so there is nothing for this criterion to evaluate, so PM4's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_stop_loss_or_nonrepeat_indel
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
PM5 N/ANot applicable: no missense change exists at this residue to compare against a different pathogenic missense change. Details ▾Hide ▴
Reasoning

PM5 (Richards et al. 2015, PMID:25741868) requires a novel missense change at an amino acid residue where a different missense change has previously been determined to be pathogenic. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, no missense change exists at this residue to compare against a different pathogenic missense change at the same position, so PM5's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
PP2 N/ANot applicable: the gene's missense-constraint properties are irrelevant because no missense change is present to evaluate. Details ▾Hide ▴
Reasoning

PP2 (Richards et al. 2015, PMID:25741868) applies to a missense variant in a gene with a low rate of benign missense variation, where missense variants are a common mechanism of disease. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, the gene's missense-constraint properties are irrelevant because no missense change is present to evaluate, so PP2's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
BP1 N/ANot applicable: the gene's truncating-variant mechanism is irrelevant because no missense change is present to evaluate. Details ▾Hide ▴
Reasoning

BP1 (Richards et al. 2015, PMID:25741868) applies to a missense variant in a gene for which primarily truncating variants are known to cause disease. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, the gene's truncating-variant mechanism is irrelevant because no missense change is present to evaluate, so BP1's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_missense
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
BP3 N/ANot applicable: as a nonsense variant, no in-frame length change occurs within a repetitive region to evaluate. Details ▾Hide ▴
Reasoning

BP3 (Richards et al. 2015, PMID:25741868) applies to in-frame insertions/deletions located in a repetitive region without a known function. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, the variant does not alter protein length within a repeat region, so there is nothing for this criterion to evaluate, so BP3's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_repeat_region_indel
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP7 N/ANot applicable: the variant is not synonymous, so the silent-variant premise of this criterion does not hold. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules

Identifiers

Gene
NF2
Transcript
NM_000268.3
Coding (HGVS c.)
NM_000268.3:c.778G>T
Protein (HGVS p.)
NP_000259.1:p.(Glu260Ter)
GRCh38
chr22:29661307 G>T
GRCh37
chr22:30057296 G>T
Location and type
Exon 8 · nonsense

Gene diagram

Every interpreted variant in NF2, mapped onto the exon structure of NM_000268.3. Select a row to find it on the plot.

NF2NM_000268.3
Fetching transcript structure from UCSC…
gnomAD v4.1 Allele count data not recorded
gnomAD v2.1 Allele count data not recorded
gnomAD-Canada v1.0 Allele count data not recorded

Statements

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Absent from gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat -102 bp
0.149
SpliceAI acceptor gainat +32 bp
0.000
SpliceAI donor lossat +32 bp
0.035
SpliceAI donor gainat +448 bp
0.006
Pangolin splice lossmagnitude shown
-0.176
Pangolin splice gain
0.042

Other predictors

REVEL
Not available
BayesDel
0.660

How the predictions were used

BP4 SupportingMet (Supporting): SpliceAI max delta 0.149 is below the ~0.2 cutoff, predicting no significant splice disruption. Details ▾Hide ▴
Reasoning

SpliceAI predicts no significant splice impact for NM_000268.3:c.778G>T, with a max delta score of 0.149 (DS_AG 0.0, DS_AL 0.149, DS_DG 0.006, DS_DL 0.035), below the ~0.2 delta-score cutoff commonly used (per the original SpliceAI validation publication) to flag a likely splicing effect. No NF2-specific VCEP PP3/BP4 lookup material is available, so this generic threshold is applied. This supports BP4 at supporting strength on the splice-impact path. The missense in-silico path (REVEL/BayesDel) is not usable to independently support or refute BP4: REVEL is not available (null) and BayesDel's 0.66 score cannot be applied because no verified published calibration threshold for BayesDel is available to this pipeline.

Rule
Generic ACMG BP4 (SpliceAI max delta score < ~0.2, based on original SpliceAI calibration thresholds), applied supporting strength; no gene-specific VCEP override present.
Evidence considered
  • SpliceAI evidence_sentence: 'SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15).' Scores: DS_AG=0.0, DS_AL=0.149, DS_DG=0.006, DS_DL=0.035; max_delta_score=0.149, below the ~0.2 SpliceAI delta-score threshold associated with likely splice-altering effects.
  • BayesDel score 0.66 (local BayesDel_170824_noAF lookup) not used because no verified published calibration threshold/PMID for BayesDel is available to this pipeline.
  • REVEL not available for this position (revel_score null).
Still missing
  • No gene-specific (NF2) VCEP-endorsed SpliceAI threshold was available; a generic ~0.2 cutoff was applied in the absence of a governing framework.
  • BayesDel score (0.66) could not be used because no verified published threshold is available to this pipeline for that predictor.
Sources
PP3 Not met: SpliceAI max delta 0.149 is below the ~0.2 cutoff for a likely splice-altering effect. Details ▾Hide ▴
Reasoning

This variant (NM_000268.3:c.778G>T, p.(Glu260Ter)) is a nonsense/stop-gain substitution. No governing VCEP or gene-specific PP3/BP4 lookup material is available for NF2 (cspec not found; vcep_materials empty), so generic ACMG in-silico evidence rules apply. On the missense in-silico path, REVEL was not computed for this variant (revel_score = null) and BayesDel returned a score (0.66) but this pipeline has no verified published threshold/table for BayesDel, so it must be treated as not_available for calibrated PP3/BP4 use regardless of the numeric value. On the splice-impact path, SpliceAI returned a max delta score of 0.149 (DS_AG 0.0, DS_AL 0.149, DS_DG 0.006, DS_DL 0.035), which falls below the ~0.2 delta-score cutoff established in the original SpliceAI validation study for flagging a likely splice-altering effect. No computational evidence therefore reaches the threshold needed to support a deleterious/splice-disrupting effect, so PP3 is not met.

Rule
Generic ACMG PP3 (SpliceAI max delta score threshold ~0.2 from Jaganathan et al. 2019 original SpliceAI calibration); missense predictors excluded as not_available (REVEL null, BayesDel uncalibrated in this pipeline).
Evidence considered
  • SpliceAI evidence_sentence: 'SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15).' Scores: DS_AG=0.0, DS_AL=0.149, DS_DG=0.006, DS_DL=0.035; max_delta_score=0.149.
  • BayesDel score 0.66 found via local BayesDel_170824_noAF lookup, but per pipeline calibration policy no verified published threshold/PMID is available for BayesDel, so it is treated as not_available for PP3/BP4 and was not used to support this determination.
  • REVEL lookup returned found=false, revel_score=null for this position; no REVEL evidence available.
Still missing
  • No gene-specific (NF2) VCEP PP3/BP4 lookup table or calibrated threshold spreadsheet was found for this case.
  • REVEL score not available for this position (revel_score null in prefetch/evidence data).
  • BayesDel score exists (0.66) but no verified published calibration threshold is available to this pipeline, so it cannot be used to support or refute PP3 for this variant.
Sources
BP7 N/ANot applicable: the variant is not synonymous, so the silent-variant premise of this criterion does not hold. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_000268.3:c.778G>T in NF2 is a nonsense substitution introducing a premature stop codon predicted to produce NP_000259.1:p.(Glu260Ter). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication, because no structured VCEP criteria-combination framework governs this case (framework_complete=false); the generic ACMG/AMP 2015 fallback applies.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: nonsense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15). BayesDel score = 0.66.

4 paper records listed. No publication is explicitly linked to an applied criterion in the recorded metadata. None of the listed paper records explicitly indicates that the variant is named.

Recorded publications

  • Neurofibromatosis type 2 (NF2): a clinical and molecular review.
    No paper-specific finding is recorded.
    PMID 19545378 ↗
  • New strategies in pleural mesothelioma: BAP1 and NF2 as novel targets for therapeutic development and risk assessment.
    No paper-specific finding is recorded.
    PMID 22825583 ↗
  • Type of mutation in the neurofibromatosis type 2 gene (NF2) frequently determines severity of disease.
    No paper-specific finding is recorded.
    PMID 8755919 ↗
  • Genotype/phenotype correlations in type 2 neurofibromatosis (NF2): evidence for more severe disease associated with truncating mutations.
    No paper-specific finding is recorded.
    PMID 9643284 ↗

Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.

All source links

Statements for reports

The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Absent from gnomAD-Canada v1.0.

ClinVar

This variant is absent from ClinVar.

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.15). BayesDel score = 0.66.

Functional

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Likely Loss-of-function; curated oncogenicity label: Likely Oncogenic.

Somatic

This variant does not lie in a statistically significant hotspot. This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.