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Variant interpretation report

GNA11 c.626A>T, p.(Gln209Leu)

NM_002067.5:c.626A>T NP_002058.2:p.(Gln209Leu) View identifiers
Classification
Pathogenic

Variant description:

No variant summary was recorded for this case.

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

Pathogenic.A pathogenic classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About GNA11

No gene-level summary was recorded for this case.

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: 6 Benign evidence criteria: 0
Pathogenic criteria applied · 6
PS3Strong
PS3 · strong

Well-established in vitro and in vivo functional studies demonstrate that GNA11 Q209L is a gain-of-function activating mutation. Van Raamsdonk et al. (2010) showed Q209L-transduced melan-a cells produced rapidly growing tumors in 6/6 injection sites in immunocompromised mice versus 0/14 controls. Moore et al. (2018) generated a conditional GNA11 Q209L mouse model that recapitulated human Gq-associated melanomas with pigmented neoplastic lesions in skin, eye, and leptomeninges. These independent lines of functional evidence confirm a deleterious gain-of-function effect.

PS4Moderate
PS4 · moderate

This variant is highly enriched in affected individuals compared to the general population. It is absent from gnomAD v2.1, v4.1, and gnomAD-Canada across all populations, yet is recurrently observed in affected tissue: COSMIC reports 442 somatic occurrences predominantly in uveal melanoma and blue nevi; it has been reported in multiple publications as the predominant GNA11 codon 209 mutation in melanocytic neoplasms; and is classified as Pathogenic/Likely Pathogenic in ClinVar. The extreme disparity between population absence and disease-associated presence supports a pathogenic role, though evidence derives predominantly from somatic and mosaic contexts.

PM2Supporting
PM2 · supporting

This variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada v1.0, indicating it is extremely rare or absent in the general population, consistent with a pathogenic role.

PP2Supporting
PP2 · supporting

GNA11 has a low rate of benign missense variation in population databases, and missense variants are the predominant pathogenic mechanism (gain-of-function at hotspot codons 183 and 209). The gene is constrained for missense variation, supporting PP2.

PP3Supporting
PP3 · supporting

In silico prediction supports a deleterious effect: REVEL score is 0.833 (strongly damaging). SpliceAI predicts no splicing impact (max delta score 0.01). BayesDel score is 0.246, borderline below typical damaging threshold. The REVEL score, combined with the location in a critical functional domain, supports a deleterious computational prediction.

PP5Supporting
PP5 · supporting

Two clinical laboratories have submitted this variant to ClinVar (variation ID 376002) with classifications of Pathogenic (SCV002525654, Seattle Children's Hospital) and Likely Pathogenic (SCV003804872, University Hospital Muenster). Both submissions are criteria-provided, single-submitter classifications. While no expert panel review is available, multiple independent clinical laboratories have reached concordant pathogenic conclusions.

Benign criteria applied · 0

No benign criterion marked as applied in the recorded assessment.

Recorded classification: Pathogenic

gene-specific framework lacked a usable explicit final combination framework, so generic ACMG/AMP 2015 final-combination rules were applied as fallback; applied criteria: PS3 strong, PS4 moderate, PM2 supporting, PP2 supporting, PP3 supporting, PP5 supporting; combination = 1 strong + 1 moderate + 4 supporting, which maps to Pathogenic.

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
0.010 maximum delta

Recorded SpliceAI maximum delta score: 0.010. Refer to the recorded PP3/BP4 rationale for interpretation.

Functional evidence
Statement recorded

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

COSMIC
Cancer Hotspots
Somatic evidence
442 recorded samples

This variant has previously been reported in somatic cancers (COSMIC; COSV50017277, n = 442 times).

Cancer Hotspots

This variant lies in a statistically significant hotspot.

For specialists

Technical detail

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

26 criteria with recorded statuses: 6 met · 12 not met · 3 not assessed · 5 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

GNA11 c.626A>T (p.Gln209Leu) is a well-characterized gain-of-function missense variant at codon 209 within the switch II functional domain, a critical region for GTPase activity and a mutational hotspot in GNA11/GNAQ-driven melanocytic neoplasms.

Functional studies demonstrate a deleterious effect: Q209L-transduced melan-a cells produced rapidly growing tumors in all 6 injection sites in immunocompromised mice compared to 0 of 14 controls (PMID:21083380), and a conditional GNA11 Q209L knock-in mouse model recapitulated human Gq-associated melanomas with multi-organ neoplastic lesions (PMID:29490280).

The variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada across all populations, yet is recurrently observed in affected tissue: COSMIC reports 442 somatic occurrences, and it has been identified as the predominant codon 209 mutation in uveal melanoma, blue nevi, cutaneous melanoma, and phakomatosis pigmentovascularis.

Two clinical laboratories in ClinVar classify this variant as Pathogenic or Likely Pathogenic (variation ID 376002). In silico prediction with REVEL (score 0.833) supports a damaging effect. GNA11 exhibits low benign missense variation in population databases, consistent with PP2.

Applying generic ACMG/AMP 2015 combination rules: PS3 (strong), PM1 (moderate), PS4 (moderate), PM2 (supporting), PP2 (supporting), PP3 (supporting), PP5 (supporting) support a classification of Pathogenic.

Met · 6

PS3 StrongWell-established in vitro and in vivo functional studies demonstrate that GNA11 Q209L is a gain-of-function activating mutation. Van Raamsdonk et al. (2010) showed Q209L-transduced melan-a cells produced rapidly growing tumors in 6/6 injection sites in immunocompromised mice versus 0/14 controls. Moore et al. (2018) generated a conditional GNA11 Q209L mouse model that recapitulated human Gq-associated melanomas with pigmented neoplastic lesions in skin, eye, and leptomeninges. These independent lines of functional evidence confirm a deleterious gain-of-function effect. Details ▾Hide ▴
Evidence considered
  • PMID:21083380: Q209L melan-a cell xenografts produced tumors in 6/6 sites vs 0/14 controls
  • PMID:29490280: conditional GNA11 Q209L mouse model recapitulated human uveal melanoma with multi-organ neoplastic lesions
  • OncoKB: Oncogenic classification
  • Gain-of-function
Sources
PS4 ModerateThis variant is highly enriched in affected individuals compared to the general population. It is absent from gnomAD v2.1, v4.1, and gnomAD-Canada across all populations, yet is recurrently observed in affected tissue: COSMIC reports 442 somatic occurrences predominantly in uveal melanoma and blue nevi; it has been reported in multiple publications as the predominant GNA11 codon 209 mutation in melanocytic neoplasms; and is classified as Pathogenic/Likely Pathogenic in ClinVar. The extreme disparity between population absence and disease-associated presence supports a pathogenic role, though evidence derives predominantly from somatic and mosaic contexts. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1
  • v4.1
  • and gnomAD-Canada
  • COSMIC: 442 somatic occurrences (COSV50017277)
  • PMID:21083380: Q209L found in 97.3% of GNA11 codon 209-mutated melanocytic neoplasms
  • PMID:26825879: Q209L reported in cutaneous melanoma
  • PMID:26778290: Q209L reported in phakomatosis pigmentovascularis
  • ClinVar: Pathogenic (1 submitter)
  • Likely pathogenic (1 submitter)
Still missing
  • Evidence derives predominantly from somatic/mosaic context
  • confirmed germline constitutional cases are limited
  • No formal case-control study with odds ratio calculation
Sources
PM2 SupportingThis variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada v1.0, indicating it is extremely rare or absent in the general population, consistent with a pathogenic role. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1 (exomes)
  • Absent from gnomAD v4.1 (exomes)
  • Absent from gnomAD-Canada v1.0 (genomes)
Sources
PP2 SupportingGNA11 has a low rate of benign missense variation in population databases, and missense variants are the predominant pathogenic mechanism (gain-of-function at hotspot codons 183 and 209). The gene is constrained for missense variation, supporting PP2. Details ▾Hide ▴
Evidence considered
  • GNA11 exhibits low benign missense variation in population databases
  • Missense gain-of-function variants at codons 183 and 209 are the established disease mechanism
  • GNA11 is constrained for missense variation (observed vs expected missense burden consistent with constraint)
Sources
PP3 SupportingIn silico prediction supports a deleterious effect: REVEL score is 0.833 (strongly damaging). SpliceAI predicts no splicing impact (max delta score 0.01). BayesDel score is 0.246, borderline below typical damaging threshold. The REVEL score, combined with the location in a critical functional domain, supports a deleterious computational prediction. Details ▾Hide ▴
Evidence considered
  • REVEL: 0.833 (damaging)
  • BayesDel: 0.246 (borderline
  • below 0.27 threshold)
  • SpliceAI: max delta 0.01 (no splicing impact)
Still missing
  • BayesDel score (0.246) is borderline and does not independently support pathogenicity
Sources
revelbayesdelspliceai ↗
PP5 SupportingTwo clinical laboratories have submitted this variant to ClinVar (variation ID 376002) with classifications of Pathogenic (SCV002525654, Seattle Children's Hospital) and Likely Pathogenic (SCV003804872, University Hospital Muenster). Both submissions are criteria-provided, single-submitter classifications. While no expert panel review is available, multiple independent clinical laboratories have reached concordant pathogenic conclusions. Details ▾Hide ▴
Evidence considered
  • ClinVar variation ID 376002: Pathogenic (1 submitter)
  • Likely pathogenic (1 submitter)
  • Both submissions are criteria-provided
  • single submitter
Still missing
  • No expert panel review or consensus classification available
Sources

Not met · 12 · evaluated, threshold not reached

PS2 No confirmed de novo occurrence with both parents tested negative. A mosaic case was reported in phakomatosis pigmentovascularis (PMID:26778290) but parental DNA was not tested and the event was postzygotic mosaic, not germline. Details ▾Hide ▴
Evidence considered
  • PMID:26778290 reported Q209L in mosaic state in a PPV patient
  • parents not tested
Still missing
  • No germline de novo event with confirmed paternity/maternity
  • Variant typically occurs as postzygotic mosaic
  • germline constitutional occurrence may be lethal
PM6 The variant was reported in a mosaic state in a patient with phakomatosis pigmentovascularis (PMID:26778290), but parents were not tested and the event was postzygotic mosaic rather than germline de novo. PM6 requires a confirmed de novo occurrence with both parents tested negative, which is not met. Details ▾Hide ▴
Evidence considered
  • PMID:26778290: Q209L detected in affected skin tissue in mosaic state
  • parental DNA not tested
Still missing
  • No germline de novo event with confirmed parental testing
  • Mosaicism precludes confident de novo assignment
PP1 No cosegregation data are available. All reported cases with this variant are sporadic, typically due to postzygotic mosaicism. Familial transmission has not been described, likely because the variant is lethal when constitutional and non-mosaic. Details ▾Hide ▴
Still missing
  • No multigenerational families available for cosegregation analysis
  • Variant predominantly occurs as postzygotic mosaic event
BA1 The variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada. Does not meet the BA1 allele frequency threshold of >1%. Details ▾Hide ▴
Evidence considered
  • Absent from all population databases
Sources
BS1 The variant is absent from gnomAD v2.1, v4.1, and gnomAD-Canada. Does not meet the BS1 allele frequency threshold of >0.3%. Details ▾Hide ▴
Evidence considered
  • Absent from all population databases
Sources
BS2 The variant is absent from all population databases. No evidence of observation in healthy homozygous adults or at allele frequencies consistent with recessive inheritance. Details ▾Hide ▴
Evidence considered
  • Absent from all population databases
  • no healthy homozygous carriers identified
Sources
BS3 Well-established in vitro and in vivo functional studies demonstrate that Q209L is a gain-of-function activating mutation, not a benign variant. Van Raamsdonk et al. (2010) showed Q209L produced tumors in 6/6 xenograft sites. Moore et al. (2018) demonstrated GNA11 Q209L mice recapitulate human melanoma. No functional evidence supports a benign effect. Details ▾Hide ▴
Evidence considered
  • PMID:21083380: Q209L is oncogenic in xenograft assays (6/6 tumors)
  • PMID:29490280: GNA11 Q209L mouse model develops melanocytic neoplasms
BP1 GNA11-related disorders are caused by gain-of-function missense variants at hotspot codons (primarily 209 and 183), not by truncating variants. BP1, which applies when truncating variants are the primary disease mechanism, is not applicable to GNA11. Details ▾Hide ▴
Evidence considered
  • GNA11 disease mechanism is gain-of-function via missense mutations at hotspot codons
  • not loss-of-function via truncating variants
BP4 REVEL predicts a damaging effect (score 0.833), contradicting a benign computational assessment. SpliceAI predicts no splicing impact (max delta 0.01), but this single benign line is insufficient to meet BP4, which requires multiple lines of computational evidence suggesting no impact. Details ▾Hide ▴
Evidence considered
  • REVEL: 0.833 (damaging
  • contradicts BP4)
  • SpliceAI: max delta 0.01 (no splicing impact
  • but insufficient alone for BP4)
Still missing
  • Only SpliceAI supports a benign prediction
  • REVEL contradicts it. Multiple benign lines are required for BP4.
Sources
BP5 No evidence has been identified that affected individuals carrying this variant have an alternate molecular basis for their phenotype. BP5 requires demonstration of a definitive alternate genetic cause in a case harboring this variant. Details ▾Hide ▴
Still missing
  • No cases identified where an alternate molecular cause was found in individuals carrying this variant
BP6 ClinVar reports this variant as Pathogenic and Likely Pathogenic (variation ID 376002). No reputable source classifies this variant as benign or likely benign. BP6 requires a reputable source to report the variant as benign. Details ▾Hide ▴
Evidence considered
  • ClinVar: Pathogenic (1 submitter)
  • Likely pathogenic (1 submitter) — not benign
Sources
PS5 No different missense change at the same residue (Gln209) has been independently established as pathogenic in a germline context. While Q209P, Q209L (by alternative nucleotide), and other codon 209 changes are observed somatically, they lack independent germline pathogenicity classification meeting PS5 requirements. Details ▾Hide ▴
Evidence considered
  • PMID:21083380 reports additional codon 209 changes (CAG→CCG/Q209P
  • CAG→CTA/Q209L-alt
  • CAG→CTT/Q209L-alt) but these lack independent germline pathogenicity classification
Still missing
  • No alternative nucleotide change at codon 209 with established germline pathogenic classification

Not assessed · 3 · no assessment recorded

PS1 No alternative nucleotide change at codon 209 producing the same amino acid substitution (p.Gln209Leu) with an established independent pathogenic classification was identified. Details ▾Hide ▴
Still missing
  • No alternative nucleotide change producing p.Gln209Leu with established germline pathogenicity was found in ClinVar or literature.
PM1 The variant is located at codon 209 within the switch II domain of Gα11, a critical functional domain essential for GTP hydrolysis. Codon 209 is a well-established mutational hotspot in GNA11 and GNAQ, with multiple independent pathogenic missense substitutions reported at this residue (Q209L, Q209P, Q209H). Mutations at this hotspot result in constitutive activation of downstream MAPK signaling. Details ▾Hide ▴
Evidence considered
  • Codon 209 lies in the switch II functional domain of Gα11
  • critical for GTPase activity
  • PMID:21083380: multiple independent substitutions at codon 209 identified in melanocytic neoplasms
  • Statistically significant hotspot per cancerhotspots.org
  • GNA11/GNAQ codon 209 is one of the most recurrently mutated residues in uveal melanoma
PP4 Insufficient patient phenotype information is available for evaluation. ClinVar submissions list conditions as 'not provided' and 'see cases' without detailed clinical descriptions. The phenotypes associated with this variant (uveal melanoma, phakomatosis pigmentovascularis, cutaneous melanoma, blue nevi) are consistent with GNA11-related disorders, but specific patient-level phenotype data are not available for formal PP4 assessment. Details ▾Hide ▴
Evidence considered
  • ClinVar submissions lack detailed clinical phenotype descriptions ('not provided'
  • 'see cases')
Still missing
  • No detailed patient phenotype data available in ClinVar submissions
  • Phenotype specificity to GNA11-related disorders cannot be formally assessed without individual-level data
Sources
Not applicable · 5· recorded as not applicable Show reasons ▾Hide reasons ▴
PVS1 N/AThis variant is a missense change (c.626A>T, p.Gln209Leu), not a null variant (nonsense, frameshift, or canonical ±1,2 splice site). Generic PVS1 framework does not apply. Details ▾Hide ▴

No further detail was recorded.

PM5 N/ANo different pathogenic missense change at the same residue (Gln209) with a confirmed germline pathogenic classification was identified for PM5 comparator analysis. PM5 candidate harvesting was unable to confirm classic same-residue PM5 semantics. Details ▾Hide ▴

No further detail was recorded.

BS4 N/ABS4 requires demonstration of non-segregation in affected family members. This variant occurs predominantly in somatic/mosaic contexts with no multigenerational families available for segregation analysis. BS4 cannot be meaningfully assessed. Details ▾Hide ▴

No further detail was recorded.

BP2 N/AGNA11-related conditions are dominant (typically mosaic-dominant). This variant has never been reported in biallelic form. BP2, which applies to recessive disorders, is not applicable. Details ▾Hide ▴

No further detail was recorded.

BP7 N/AThis variant is a missense change (c.626A>T, p.Gln209Leu), not a synonymous variant. BP7 applies only to synonymous variants with no predicted splice impact. Details ▾Hide ▴

No further detail was recorded.

Identifiers

Gene
GNA11
Transcript
NM_002067.5
Coding (HGVS c.)
NM_002067.5:c.626A>T
Protein (HGVS p.)
NP_002058.2:p.(Gln209Leu)
GRCh38
chr19:3118944 A>T
GRCh37
chr19:3118942 A>T
ClinVar
376002, 3238640
COSMIC
COSV50017277

Gene diagram

Every interpreted variant in GNA11, mapped onto the exon structure of NM_002067.5. Select a row to find it on the plot.

GNA11NM_002067.5
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 +2 bp
0.000
SpliceAI acceptor gainat +73 bp
0.010
SpliceAI donor lossat -352 bp
0.000
SpliceAI donor gainat -116 bp
0.000
Pangolin splice lossmagnitude shown
-0.000
Pangolin splice gain
0.000

Other predictors

REVEL
0.833
BayesDel
0.246

How the predictions were used

PP3 SupportingIn silico prediction supports a deleterious effect: REVEL score is 0.833 (strongly damaging). SpliceAI predicts no splicing impact (max delta score 0.01). BayesDel score is 0.246, borderline below typical damaging threshold. The REVEL score, combined with the location in a critical functional domain, supports a deleterious computational prediction. Details ▾Hide ▴
Evidence considered
  • REVEL: 0.833 (damaging)
  • BayesDel: 0.246 (borderline
  • below 0.27 threshold)
  • SpliceAI: max delta 0.01 (no splicing impact)
Still missing
  • BayesDel score (0.246) is borderline and does not independently support pathogenicity
Sources
revelbayesdelspliceai ↗
BP4 REVEL predicts a damaging effect (score 0.833), contradicting a benign computational assessment. SpliceAI predicts no splicing impact (max delta 0.01), but this single benign line is insufficient to meet BP4, which requires multiple lines of computational evidence suggesting no impact. Details ▾Hide ▴
Evidence considered
  • REVEL: 0.833 (damaging
  • contradicts BP4)
  • SpliceAI: max delta 0.01 (no splicing impact
  • but insufficient alone for BP4)
Still missing
  • Only SpliceAI supports a benign prediction
  • REVEL contradicts it. Multiple benign lines are required for BP4.
Sources
BP7 N/AThis variant is a missense change (c.626A>T, p.Gln209Leu), not a synonymous variant. BP7 applies only to synonymous variants with no predicted splice impact. Details ▾Hide ▴

No further detail was recorded.

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.833. BayesDel score = 0.245583.

8 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

  • Mutations in GNA11 in uveal melanoma.
    Van Raamsdonk CD et al. · 2010
    No paper-specific finding is recorded.
    PMID 21083380 ↗
  • GNA11 Mutation in a Patient With Cutaneous Origin Melanoma: A Case Report.
    No paper-specific finding is recorded.
    PMID 26825879 ↗
  • GNA11 Q209L Mouse Model Reveals RasGRP3 as an Essential Signaling Node in Uveal Melanoma.
    No paper-specific finding is recorded.
    PMID 29490280 ↗
  • The emerging mutational landscape of G proteins and G-protein-coupled receptors in cancer.
    O'Hayre M et al. · 2013
    No paper-specific finding is recorded.
    PMID 23640210 ↗
  • Combined PKC and MEK inhibition in uveal melanoma with GNAQ and GNA11 mutations.
    Chen X et al. · 2014
    No paper-specific finding is recorded.
    PMID 24141786 ↗
  • Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology.
    Richards S et al. · 2015
    No paper-specific finding is recorded.
    PMID 25741868 ↗
  • Mosaic Activating Mutations in GNA11 and GNAQ Are Associated with Phakomatosis Pigmentovascularis and Extensive Dermal Melanocytosis.
    Thomas AC et al. · 2016
    No paper-specific finding is recorded.
    PMID 26778290 ↗
  • American College of Medical Genetics and Genomics technical standards and guidelines: microarray analysis for chromosome abnormalities in neoplastic disorders.
    Cooley LD et al. · 2013
    No paper-specific finding is recorded.
    PMID 23619274 ↗

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 has been reported in ClinVar as Pathogenic (1 clinical laboratory) and as Likely pathogenic (1 clinical laboratory). (ClinVarID = 376002)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.833. BayesDel score = 0.245583.

Functional

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

Somatic

This variant lies in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV50017277, n = 442 times).

Cancer Hotspots

This variant lies in a statistically significant hotspot.