Five-step scale from benign to pathogenic. This variant is uncertain. Select a step to read what it means.
This variantScenario
BenignPathogenic
Uncertain.The recorded classification is uncertain significance.
In plain language
Gene-level background from the recorded interpretation.
Words with a dotted underline have a short definition. Hover or tap them.
About BRIP1
BRIP1 encodes a helicase enzyme that partners with the BRCA1 protein to repair double-strand breaks in DNA, a process essential for maintaining genome stability. Germline mutations in this gene predispose carriers to ovarian cancer, and inheriting two faulty copies causes Fanconi anemia complementation group J, a rare disorder of impaired DNA repair. BRIP1 acts as a tumor suppressor, so loss of its function raises cancer risk, particularly in the ovary.
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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.
Met (supporting): gnomAD v4.1 total allele frequency is 2.66e-05 (43/1,613,968), below the 0.1% PM2 threshold.
PP3Moderate
PP3 · moderate
Met (moderate): REVEL score 0.804 falls in the ClinGen-calibrated Pathogenic Moderate band (>=0.773).
Benign criteria applied · 0
No benign criterion marked as applied in the recorded assessment.
Recorded classification: Uncertain significance
No BRIP1-specific framework exists, so generic ACMG/AMP 2015 rules applied; only PM2 (supporting) and PP3 (moderate) were met, satisfying no combining rule, yielding a classification of VUS.
02The sources
Evidence at a glance
Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.
gnomAD v4.1
gnomAD v2.1
Population frequency
43 / 1,613,968 alleles
gnomAD v4.1: 43 / 1,613,968 alleles. Recorded AF 2.66424e-05. Recorded homozygote count 0.
gnomAD v2.1
This variant is present in gnomAD v2.1 (AF= 2.83968e-05; MAF= 0.00284%, 8/281722 alleles, homozygotes = 0) and has highest observed frequency in the East Asian population (AF= 5.01354e-05; MAF= 0.00501%, 1/19946 alleles, homozygotes = 0); grpmax FAF= 5.239e-05.
ACMG/AMP criteria under Not recorded, with the data and sources behind each one.
28 criteria with recorded statuses: 2 met · 7 not met · 15 not assessed · 4 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.
No official ClinGen VCEP/CSPEC exists for BRIP1 (framework_mode=generic_acmg, cspec.found=false); generic ACMG/AMP 2015 criteria were applied for all five criteria in this group.
The case's pm5_candidates.json artifact explicitly declined automatic same-residue harvesting, leaving PM5 (and by extension PS1, which also depends on same-residue/same-change comparator data) without sufficient supporting data to assess as met or not_met.
PMID:31822495 (functional characterization of BRIP1 missense variants in the helicase domain) was the only source found bearing directly on domain/mechanism criteria (PM1, PP2, BP1) and was read in full text for this reason.
Cancerhotspots.org was directly queried for BRIP1 R865 and returned no statistically significant hotspot, supporting a not_met call for PM1.
No missense constraint metric (gnomAD missense Z-score / o:e) was available in the bundle to complete the second required element of PP2, so PP2 was left not_assessed rather than inferred.
PS3 and BS3 both require validated functional assay data for the specific variant; none was located in the case bundle, prefetch, evidence.json, or in full-text search of all cited publications (searched for '865', 'Arg865', 'R865W', 'p.R865' — no matches in any retrieved full text).
No BRIP1-specific ClinGen VCEP CSPEC or PP3/BP4 lookup spreadsheet is present in this case (cspec.found=false; vcep_materials files_found=[]); generic ACMG/AMP calibrated in-silico thresholds were applied.
REVEL = 0.804 meets the ClinGen SVI (Pejaver 2022, PMID 36413997) Pathogenic-Moderate calibration band (>=0.773), supporting PP3 at moderate strength for this missense variant.
BayesDel (0.398139) was retrieved but excluded from PP3/BP4 determination per pipeline policy: no verified published calibration threshold/PMID is available for BayesDel.
SpliceAI max delta = 0.066 shows no splice-disrupting signal; this is a neutral/non-contributory finding for a missense variant and does not itself support either PP3 or BP4.
BP7 is not applicable — the variant is missense (p.Arg865Trp), not synonymous.
No criteria match.
Met · 2
PM2SupportingMet (supporting): gnomAD v4.1 total allele frequency is 2.66e-05 (43/1,613,968), below the 0.1% PM2 threshold.
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Reasoning
No BRIP1 VCEP/ClinGen gene-specific specification was retrieved. The variant is present but extremely rare across gnomAD releases: v4.1 total AF 2.66424e-05 (43/1,613,968), highest major ancestry-group AF 3.2941e-05 (South Asian), and v2.1 total AF 2.83968e-05. All are below the generic non-VCEP PM2 operating threshold of 0.1%; PM2 is met at supporting strength. The observed alleles and absence of homozygotes do not constitute benign frequency evidence.
Rule
generic_non_vcep_population_operating_threshold: PM2_supporting for AF <0.1%
Evidence considered
gnoMAD v4.1: 43/1,613,968 alleles (AF 2.66424e-05), South Asian 3/91,072 (AF 3.2941e-05), zero homozygotes, and grpmax FAF 2.314e-05.
gnoMAD v2.1: 8/281,722 alleles (AF 2.83968e-05), zero homozygotes, and grpmax FAF 5.239e-05.
PP3ModerateMet (moderate): REVEL score 0.804 falls in the ClinGen-calibrated Pathogenic Moderate band (>=0.773).
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Reasoning
NM_032043.3:c.2593C>T (p.Arg865Trp) is a missense variant. No governing VCEP/CSPEC is available for BRIP1 (cspec.found=false; vcep_materials.final_classification_framework.found=false, framework falls back to generic ACMG/AMP 2015), and no gene-specific PP3/BP4 lookup spreadsheet was provided, so the generic calibrated in-silico approach applies. REVEL score = 0.804, which falls within the ClinGen SVI (Pejaver et al. 2022, PMID 36413997) calibrated 'Pathogenic Moderate' band (REVEL >= 0.773) for missense in-silico evidence, supporting PP3 at moderate strength. BayesDel score (0.398139) was also computed but is not used to support or contradict this call: no verified published calibration threshold/PMID for BayesDel is available to this pipeline, so per policy it is treated as not_available regardless of the raw score. SpliceAI predicts no meaningful splice disruption (max delta score = 0.066, well below any splice-altering threshold), so the splice-impact path is silent/non-contributory here (neither supports nor conflicts with the missense PP3 call) and is not itself sufficient to invoke PP3 via splicing. Align-GVGD/HCI prior data were not available for this variant (hci_prior.found=false).
Rule
REVEL >= 0.773 (ClinGen SVI Pejaver 2022 calibration, PMID 36413997) => PP3_Moderate for missense variant with no applicable VCEP override
Evidence considered
REVEL score = 0.804 for NM_032043.3:c.2593C>T (source_registry key 'revel'), meeting the ClinGen SVI calibrated Pathogenic-Moderate threshold (REVEL >= 0.773) from Pejaver et al. 2022, PMID 36413997.
SpliceAI predicts no significant splice impact (max delta score = 0.066; DS_AG=0.001, DS_AL=0.021, DS_DG=0.002, DS_DL=0.066), indicating the splice-loss pathway is not activated and does not itself drive PP3.
No CSPEC/VCEP-specific PP3/BP4 lookup spreadsheet exists for BRIP1 in this case (vcep_materials.json: files_found=[], summaries={}), so generic ACMG calibrated thresholds were applied.
BayesDel score (0.398139) was retrieved but withheld from criterion determination because no verified published calibration threshold/PMID for BayesDel is available to this pipeline.
Still missing
aGVGD/HCI-prior score not available for this variant
No BRIP1-specific VCEP PP3/BP4 lookup table exists to confirm or override the generic REVEL-based call
BayesDel score exists but cannot be used due to lack of a citable calibrated publication/threshold in this pipeline
Sources
revel
Not met · 7 · evaluated, threshold not reached
PM1Not met: Cancerhotspots.org returned no statistically significant hotspot at residue 865.
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Reasoning
No ClinGen VCEP/CSPEC exists for BRIP1, so generic ACMG PM1 was applied. Cancerhotspots.org was queried directly for 'BRIP1 R865' and explicitly returned no statistically significant hotspot at this residue. PMID:31822495 describes p.Arg865Trp as falling within the broad, 888-amino-acid BRIP1 helicase domain, but that domain is not characterized as free of benign missense variation -- the paper explicitly documents a mix of wildtype-like, hypomorphic, and null missense alleles scattered across the same domain, and residue 865 itself is not identified as one of the seven conserved DEAH helicase motifs, the Fe-S binding cluster, or any other discretely critical subregion. No mutational cluster or case-control enrichment statistic specific to residue 865 was found.
Evidence considered
Cancerhotspots.org query for 'BRIP1 R865' returned: 'This variant does not lie in a statistically significant hotspot' (no hotspot row found).
PMID:31822495 states the N-terminal region comprises seven highly conserved DEAH helicase motifs (aa ~1-349) plus an Fe-S binding domain, and that 54-of-64 rare missense alleles identified in their cohorts clustered within the broadly defined helicase domain (1-888 aa), but that domain as a whole contains a mix of functionally wildtype, hypomorphic, and null alleles (e.g., Q740H and A745T were classified wildtype-like at nearby residues in the C-terminal helicase region), indicating no residue-865-specific critical subdomain devoid of benign variation was established.
Still missing
No case-control/statistical enrichment data specific to codon 865 or its immediate flanking residues.
No published sub-domain annotation confirming residue 865 lies in one of the seven catalytically essential DEAH motifs versus the broader non-critical helicase region.
PP5Not met: the ClinVar record lacks expert-panel submissions and is classified as uncertain significance by laboratory submitters.
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Reasoning
The exact-variant ClinVar record has no expert-panel submissions and is classified as uncertain significance by laboratory submitters. It does not meet the required exact-variant ClinVar expert-panel Pathogenic/Likely pathogenic condition for PP5.
Rule
Apply PP5 only for an exact-variant ClinVar expert-panel Pathogenic or Likely pathogenic assertion.
Evidence considered
ClinVar variation 230320 exactly matches NM_032043.3(BRIP1):c.2593C>T (p.Arg865Trp); the submission audit reports zero expert-panel submissions and the record-level classification is uncertain significance.
BA1Not met: highest gnomAD v4.1 population allele frequency is 3.29e-05, far below the 5% BA1 threshold.
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Reasoning
No BRIP1 VCEP/ClinGen gene-specific specification was retrieved, so generic ACMG/AMP population-frequency logic applies. The highest robust gnomAD v4.1 population AF is 3.2941e-05 (South Asian; 3/91,072 alleles), with grpmax filtering allele frequency 2.314e-05. These values are far below the generic BA1 stand-alone benign frequency threshold of 5%; BA1 is not met.
Rule
generic_acmg_amp: BA1 requires allele frequency >5% in an appropriate population dataset
Evidence considered
gnoMAD v4.1 reports 43/1,613,968 alleles (AF 2.66424e-05), no homozygotes, South Asian population AF 3.2941e-05 (3/91,072), and grpmax FAF 2.314e-05.
Independent gnomAD v2.1 data show 8/281,722 alleles (AF 2.83968e-05), no homozygotes, and grpmax FAF 5.239e-05.
BS1Not met: gnomAD allele frequencies (maximum 3.29e-05) are below the 0.3% BS1 threshold.
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Reasoning
No BRIP1 VCEP/ClinGen gene-specific frequency threshold was retrieved. Under the generic non-VCEP operating threshold (BS1 >0.3%), the observed gnomAD frequencies are much lower: v4.1 total AF 2.66424e-05, highest major ancestry-group AF 3.2941e-05, and grpmax FAF 2.314e-05. BS1 is not met.
Rule
generic_non_vcep_population_operating_threshold: BS1 requires AF >0.3%
Evidence considered
gnoMAD v4.1 has 43 alternate alleles among 1,613,968 alleles and no homozygotes; the highest major ancestry-group observation is South Asian, 3/91,072 alleles.
gnoMAD v2.1 independently reports 8/281,722 alleles, no homozygotes, and a maximum population AF of 5.01354e-05 in East Asian individuals.
BP1Not met: BRIP1 missense variants are an established disease mechanism, so missense cannot be presumed benign.
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Reasoning
No ClinGen VCEP/CSPEC exists for BRIP1, so generic ACMG BP1 was applied. BP1 requires that the gene's disease mechanism is exclusively or predominantly via truncating/loss-of-function variants such that missense variants are not expected to be pathogenic. PMID:31822495 directly contradicts this premise: it functionally demonstrates that specific BRIP1 missense substitutions (A349P, P47A, G690E, D791V and others) cause loss-of-function or hypomorphic ICL-repair defects and are enriched among breast/ovarian cancer patients relative to population controls, confirming missense variation is an established BRIP1 pathogenic mechanism. BP1 is therefore not met for this gene.
Evidence considered
PMID:31822495 functionally classifies multiple BRIP1 missense alleles (A349P, P47A, G690E as null; D791V and others as hypomorphic) as pathogenic loss-of-function variants via ICL-damage sensitivity, karyotype, and protein-stability assays, establishing that missense variation is a recognized BRIP1 disease mechanism and precluding application of BP1.
BP4Not met: REVEL 0.804 falls in the pathogenic direction, so no benign in-silico evidence applies.
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Reasoning
The calibrated missense in-silico predictor (REVEL = 0.804) falls in the Pathogenic-Moderate range per ClinGen SVI calibration (PMID 36413997), i.e. in the pathogenic direction, not the benign direction, so BP4 cannot be applied for the missense path. SpliceAI shows no splice disruption (max delta = 0.066), which is simply an absence of a splicing signal for this missense variant rather than an independent benign in-silico protein-effect prediction, and is not sufficient on its own to invoke BP4 for a missense variant already showing a pathogenic-direction missense score. No VCEP-specific PP3/BP4 lookup override exists for BRIP1 to redirect this call.
Rule
REVEL >= 0.773 excludes BP4 under the missense in-silico path; SpliceAI absence-of-effect alone is insufficient for BP4 in a missense variant already carrying a pathogenic-direction predictor score
Evidence considered
REVEL score = 0.804 places the variant in the pathogenic-direction (Moderate) calibrated band per Pejaver et al. 2022 (PMID 36413997), precluding a benign-direction BP4 call from the missense path.
SpliceAI predicts no significant splice impact (max delta score = 0.066), which is neutral for the missense in-silico path and not used to independently invoke BP4.
Still missing
No BRIP1-specific VCEP PP3/BP4 lookup table exists to confirm or override this generic determination
BP6Not met: the ClinVar record has no expert-panel Benign/Likely benign assertion.
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Reasoning
The exact-variant ClinVar record has no expert-panel submissions and no Benign/Likely benign expert-panel assertion. It therefore does not meet the required condition for BP6.
Rule
Apply BP6 only for an exact-variant ClinVar expert-panel Benign or Likely benign assertion.
Evidence considered
ClinVar variation 230320 exactly matches NM_032043.3(BRIP1):c.2593C>T (p.Arg865Trp); the submission audit reports zero expert-panel submissions and the record-level classification is uncertain significance.
PS1Not assessed: no alternate nucleotide change producing the identical p.Arg865Trp change with an established pathogenic classification was available.
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Reasoning
No ClinGen VCEP/CSPEC exists for BRIP1 (cspec.found=false; framework_mode=generic_acmg), so generic ACMG PS1 applies. PS1 requires a different nucleotide change producing the identical amino acid change (p.Arg865Trp) already established as pathogenic. No such comparator variant is present anywhere in the case bundle, ClinVar criterion-lead PMID trail, or PM5 candidate scan.
Evidence considered
pm5_candidates.json explicitly reports 'Unable to confirm classic same-residue PM5 semantics safely; skipping automatic candidate harvesting,' and no same-amino-acid-change comparator data was located elsewhere in the bundle.
Still missing
No search result identifying another codon 865 variant encoding the same Trp substitution with an established pathogenic classification was found in the bundle.
PS2Not assessed: no proband phenotype, parental genotypes, or parentage confirmation were available for this variant.
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Reasoning
Not assessed: the case bundle contains no proband phenotype, parental genotypes, or parentage confirmation for BRIP1 c.2593C>T (p.Arg865Trp).
Rule
Generic ACMG/AMP 2015 de novo criterion (PS2); no BRIP1 VCEP/CSPEC was retrieved.
Evidence considered
ClinVar reports the exact variant but the bundled submission data provide no parental genotypes, parentage testing, or proband phenotype details.
Under the generic ACMG/AMP framework, PS2 requires a de novo observation with negative parental samples and confirmed biological parentage.
Still missing
Obtain parental testing results for the exact variant in the proband.
If both parents test negative, obtain confirmation of biological parentage and assess whether the proband phenotype is sufficiently specific and consistent with the relevant BRIP1-associated disorder.
PS3Not assessed: no validated functional assay data on this variant were found in any cited publication.
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Reasoning
No gene-specific VCEP/CSPEC was found for BRIP1 in this case (framework_mode = generic_acmg, cspec.found = false), so generic ACMG applies. Searched all full-text cited publications (PMID:31822495, PMID:29368626, PMID:25741868, PMID:26467025, PMID:17392385, PMID:24366376, PMID:26324357) and the case bundle for any validated functional/biochemical assay data on NM_032043.3:c.2593C>T (p.Arg865Trp) — e.g. helicase/ATPase activity, ICL repair complementation, foci formation, reversion assays. None of the cited full texts mention this specific variant or residue (865/R865W) despite PMID:31822495 being a BRIP1 missense functional-assay paper flagged 'functional' theme; its abstract describes cell-based functional assays for a panel of rare BRIP1 missense alleles but the variant identity within that panel could not be confirmed against this exact substitution in the retrieved text. No case-specific functional assay results are present in evidence.json/prefetch.json.
Still missing
No validated functional/biochemical assay evidence (e.g. ICL repair complementation, helicase activity, foci formation) located for this exact variant p.Arg865Trp in any source available to this case.
PMID:31822495 (Moyer et al., rare BRIP1 missense functional assays) should be manually checked for whether p.R865W/c.2593C>T specifically was among the tested alleles, since full-text grep for '865' did not match (possible formatting/OCR issue in extracted text).
PS4Not assessed: no case-control dataset reported carrier counts for this variant in affected individuals versus controls.
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Reasoning
No applicable BRIP1 VCEP specification was retrieved; generic ACMG/AMP is therefore used. No case-control dataset in the evidence bundle reports an exact-variant carrier count for c.2593C>T (p.Arg865Trp) in affected individuals and controls, so enrichment cannot be assessed.
Rule
Generic ACMG/AMP PS4: increased prevalence in affected individuals compared with controls requires variant-specific enrichment evidence.
Evidence considered
The exact ClinVar record identifies NM_032043.3:c.2593C>T (p.Arg865Trp), but its 17 submissions are uncertain-significance laboratory submissions and provide no case-control carrier counts.
Targeted full-text searches of PMID:31822495 and PMID:29368626 for R865W, Arg865Trp, c.2593, and 2593C found no exact-variant mention; these papers therefore cannot supply PS4 evidence for this variant.
Still missing
An exact-variant case-control study with affected and control carrier counts, or equivalent statistically interpretable enrichment data.
PM3Not assessed: no affected individual carrying this variant together with a second pathogenic BRIP1 allele was reported.
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Reasoning
No affected individual with c.2593C>T reported together with a second pathogenic/likely pathogenic BRIP1 allele, and no phase evidence, is provided. PM3 cannot be applied.
Rule
Generic ACMG/AMP PM3: a variant must be observed in trans with a pathogenic variant in an affected individual for a recessive disorder.
Evidence considered
No BRIP1 VCEP/CSPEC or local gene-specific framework was available; generic ACMG/AMP assessment was used.
The ClinVar record for the exact variant reports an uncertain-significance aggregate and lists condition labels, but the consolidated record supplies no affected-proband genotype with a second BRIP1 pathogenic/likely pathogenic allele and no cis/trans phase information.
Still missing
Affected-proband observations for a recessive BRIP1 condition with c.2593C>T and a second BRIP1 pathogenic/likely pathogenic variant.
Parental or other reliable phase data demonstrating that the two alleles are in trans.
PM5Not assessed: no alternate missense change at codon 865 with an established pathogenic classification was identified.
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Reasoning
No ClinGen VCEP/CSPEC exists for BRIP1, so generic ACMG PM5 was applied. The case's own PM5 candidate harvesting step explicitly declined to run a same-residue ClinVar search ('Unable to confirm classic same-residue PM5 semantics safely; skipping automatic candidate harvesting'), and no alternate missense change at codon 865 (e.g., p.Arg865Gln, p.Arg865Leu, p.Arg865Gly) with an established pathogenic/likely pathogenic classification appears anywhere else in the bundle.
Evidence considered
pm5_candidates.json: pm5_mode='unknown', eligible_for_classic_pm5_search=false, candidate_summary.same_residue_candidates=0, recommendation.level='not_applicable' with instruction to review manually before applying PM5; no candidates were harvested.
Still missing
A dedicated ClinVar/literature search for other pathogenic or likely pathogenic missense variants at BRIP1 codon 865 has not been performed for this case.
PM6Not assessed: no report of this variant arising de novo in a proband with confirmed parental samples was available.
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Reasoning
Not assessed: there is no report that the exact variant was de novo in a proband with parental samples negative and parentage unconfirmed.
Rule
Generic ACMG/AMP 2015 de novo criterion (PM6); no BRIP1 VCEP/CSPEC was retrieved.
Evidence considered
ClinVar reports the exact variant but the bundled submission data provide no parental genotypes, parentage testing, or proband phenotype details.
The generic ACMG/AMP framework specifies PM6 when de novo status is observed but biological parentage is assumed rather than confirmed.
Still missing
Obtain parental testing results for the exact variant in the proband.
Document whether biological parentage was confirmed; if it was not confirmed but both parents test negative, determine whether the proband phenotype and inheritance context support PM6.
PP1Not assessed: no evaluable family segregation data were available.
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Reasoning
Not assessed: no evaluable family-level genotype/phenotype data or informative meioses are supplied. A ClinVar submission narrative reports that the variant did not co-segregate in one melanoma-affected family, so it cannot support PP1, but the underlying pedigree and genotypes are not available to quantify segregation.
Rule
Generic ACMG/AMP 2015 segregation criterion (PP1); no BRIP1 VCEP/CSPEC was retrieved.
Evidence considered
The ClinVar submission-audit evidence states that the variant was reported in one individual with melanoma from a melanoma-affected family but did not co-segregate with disease; no primary pedigree, genotype table, or meiosis count is included in the bundle.
Still missing
Obtain the primary family report or pedigree with the exact variant genotypes, phenotypes, ages, and number of informative meioses.
Establish whether the reported melanoma phenotype is an appropriate BRIP1-associated phenotype before using it for segregation assessment.
PP2Not assessed: missense is a recognized BRIP1 disease mechanism, but no missense constraint metric was available.
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Reasoning
No ClinGen VCEP/CSPEC exists for BRIP1, so generic ACMG PP2 was applied. Generic PP2 requires both (1) missense being a recognized mechanism of disease in the gene and (2) a low rate of benign missense variation in the gene. PMID:31822495 supports the first element -- it functionally characterizes multiple BRIP1 missense alleles (e.g., A349P, P47A, G690E, D791V) as hypomorphic or null and causally linked to Fanconi anemia / ICL-repair deficiency, establishing missense as a recognized BRIP1 disease mechanism. However, no missense constraint metric (e.g., gnomAD missense Z-score or observed/expected ratio) was located anywhere in the bundle to establish the second required element (rate of benign missense variation in this gene), and the same paper also notes 933-of-950 ClinVar BRIP1 missense variants are VUS, not benign, which does not itself establish a low benign-missense rate.
Evidence considered
PMID:31822495 documents functional characterization of 20 BRIP1 missense alleles in the helicase domain: 6 classified null (e.g., A349P, G690E), 9 hypomorphic (e.g., P47A, D791V), and 5 wildtype-like, establishing missense substitution as a bona fide BRIP1 pathogenic mechanism causing loss of ICL-repair function.
PMID:31822495 also reports 933-of-950 BRIP1 missense variants in ClinVar (as of May 2019) are classified VUS, which does not confirm a low rate of benign missense variation as required for the second PP2 element.
Still missing
Missense constraint metric (gnomAD missense Z-score / o:e ratio, or gene-specific benign-missense-rate data) for BRIP1 was not present in the case bundle.
PP4Not assessed: no proband phenotype data demonstrating specificity for a BRIP1-related disorder were available.
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Reasoning
No applicable BRIP1 VCEP phenotype-specific specification was retrieved. The evidence bundle contains no proband phenotype, diagnostic workup, or phenotype-frequency data demonstrating that the presenting phenotype is highly specific for a BRIP1-related disorder.
Rule
Generic ACMG/AMP PP4: apply only when the patient's phenotype or family history is highly specific for a disease with a single genetic etiology.
Evidence considered
ClinVar condition labels are record-level labels and do not document the phenotype of an individual carrying this exact variant.
Still missing
A documented proband phenotype and differential-diagnosis workup demonstrating high specificity for the relevant BRIP1-associated condition.
BS2Not assessed: no phenotype- and age-ascertained observations of this variant in healthy adults were available.
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Reasoning
The available population datasets establish rarity but do not provide phenotype- and age-ascertained observations of the exact variant in healthy adults sufficient for BS2. Zero homozygotes in gnomAD v2.1 and v4.1 does not supply BS2 evidence.
Rule
generic_acmg_amp: BS2 requires observation in healthy adults for a disorder expected to be fully penetrant at an early age
Evidence considered
gnoMAD v4.1 reports zero homozygotes among 43 alternate alleles; gnomAD v2.1 reports zero homozygotes among 8 alternate alleles. Neither dataset provides the required unaffected-adult phenotype evidence.
Still missing
Need documented observations of NM_032043.3:c.2593C>T in well-phenotyped, age-appropriate unaffected individuals, interpreted in the relevant BRIP1 disease context.
BS3Not assessed: no functional assay evidence of normal protein activity for this variant was found.
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Reasoning
No gene-specific VCEP/CSPEC was found for BRIP1 (generic ACMG fallback). No functional assay evidence demonstrating normal/wild-type-like activity for NM_032043.3:c.2593C>T (p.Arg865Trp) was found in any cited full-text publication or in the case evidence files. PMID:31822495 describes a functional assay panel of BRIP1 missense alleles but this variant's presence and result in that panel could not be confirmed in the retrieved full text.
Still missing
No functional assay data (of any result direction) located for this exact variant in the sources available to this case.
BS4Not assessed: the reported lack of co-segregation in one family was insufficiently documented to establish non-segregation.
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Reasoning
Not assessed: the reported lack of co-segregation in a single melanoma-affected family is insufficiently documented to establish strong non-segregation evidence. The bundle lacks the pedigree, relative-level genotypes and phenotypes, and an assessment of phenotype relevance and penetrance.
Rule
Generic ACMG/AMP 2015 non-segregation criterion (BS4); no BRIP1 VCEP/CSPEC was retrieved.
Evidence considered
The ClinVar submission-audit evidence reports non-co-segregation in a melanoma-affected family but supplies neither the underlying pedigree nor relative-level genotype/phenotype data required to evaluate the observation as strong BS4 evidence.
Still missing
Obtain the primary family report or pedigree with the exact variant genotypes and disease status of informative relatives.
Confirm phenotype relevance, ages, and penetrance considerations before evaluating non-segregation as BS4.
BP2Not assessed: no observation placed this variant in cis or trans with a pathogenic allele.
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Reasoning
No observation places c.2593C>T in cis or trans with a pathogenic/likely pathogenic allele in a context that would support BP2. BP2 cannot be applied.
Rule
Generic ACMG/AMP BP2: the variant is observed in cis with a pathogenic variant, or in trans with a pathogenic variant for a fully penetrant dominant disorder.
Evidence considered
No BRIP1 VCEP/CSPEC or local gene-specific framework was available; generic ACMG/AMP assessment was used.
The consolidated ClinVar record contains no co-occurring pathogenic/likely pathogenic allele, phase assignment, or phenotype evidence from which a non-causative cis/trans co-occurrence can be established.
Still missing
A documented co-occurrence of c.2593C>T with a pathogenic/likely pathogenic allele, including confirmed phase and phenotype/inheritance context showing that the co-occurrence is non-causative.
BP5Not assessed: no data established that the phenotype is explained by an alternative molecular diagnosis.
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Reasoning
No individual-level phenotype or molecular diagnostic result is provided to establish that the observed phenotype is fully explained by an alternative molecular diagnosis.
Rule
Generic ACMG/AMP BP5: apply when a variant is found in a case with an alternate molecular basis for disease.
Evidence considered
The evidence bundle contains population, ClinVar, and literature-triage data, but no case-level alternative molecular diagnosis.
Still missing
Individual-level evidence of a confirmed alternative molecular diagnosis that fully explains the relevant phenotype.
Not applicable · 4· recorded as not applicableShow reasons ▾Hide reasons ▴PVS1N/ANot applicable: this missense substitution triggers no null-variant mechanism such as nonsense-mediated decay.
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Reasoning
PVS1 (ClinGen SVI PVS1 recommendations, PMC6185798, pvs1_generic_framework) applies only to null variant classes — nonsense, frameshift, canonical ±1/2 splice-consensus, translation-initiation-codon loss, and stop-loss variants — each expected to trigger nonsense-mediated decay or otherwise abolish normal protein function. NM_032043.3:c.2593C>T in BRIP1 is a missense substitution predicted to produce NP_114432.2:p.(Arg865Trp). As a result, no null-variant mechanism (nonsense-mediated decay, truncation, or canonical splice disruption) is triggered by this variant class, so PVS1'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.
PM4N/ANot applicable: missense substitution produces no change in protein length.
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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_032043.3:c.2593C>T in BRIP1 is a missense substitution predicted to produce NP_114432.2:p.(Arg865Trp). 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.
BP3N/ANot applicable: this is a missense substitution, not an in-frame indel in a repetitive region.
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Reasoning
BP3 (Richards et al. 2015, PMID:25741868) applies to in-frame insertions/deletions located in a repetitive region without a known function. NM_032043.3:c.2593C>T in BRIP1 is a missense substitution predicted to produce NP_114432.2:p.(Arg865Trp). 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.
BP7N/ANot applicable: this is a missense substitution, not a synonymous variant.
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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_032043.3:c.2593C>T in BRIP1 is a missense substitution predicted to produce NP_114432.2:p.(Arg865Trp). 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: missense (prefetch.json normalized protein consequence)
Sources
generic_acmg_combination_rules
Identifiers
Gene
BRIP1
Transcript
NM_032043.3
Coding (HGVS c.)
NM_032043.3:c.2593C>T
Protein (HGVS p.)
NP_114432.2:p.(Arg865Trp)
GRCh38
chr17:61686148 G>A
GRCh37
chr17:59763509 G>A
Location and type
Exon 19 · missense
ClinVar
230320
COSMIC
COSV51997487
Gene diagram
Every interpreted variant in BRIP1, mapped onto the exon structure of NM_032043.3. Select a row to find it on the plot.
BRIP1NM_032043.3
Fetching transcript structure from UCSC…
Exons
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Transcript span
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Strand
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Variants mapped
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Source
UCSC ncbiRefSeqCurated
All variants in BRIP1—Select a row to find it on the plot; use the link to open its page.
AF 2.7e-05 · 43 / 1,613,968 alleles · 0 hom · FAF 2.3e-05
South Asian3 / 91,072
3.3e-05
Remaining individuals2 / 62,502
3.2e-05
European (non-Finnish)37 / 1,179,920
3.1e-05
East Asian1 / 44,860
2.2e-05
0 alternate alleles recorded in 6 other groups: Admixed American, European (Finnish), Amish, Middle Eastern, Ashkenazi Jewish, African/African American.
gnomAD v2.1
AF 2.8e-05 · 8 / 281,722 alleles · 0 hom · FAF 5.2e-05
East Asian1 / 19,946
5e-05
European (non-Finnish)6 / 128,716
4.7e-05
South Asian1 / 30,608
3.3e-05
0 alternate alleles recorded in 5 other groups: African/African American, Admixed American, Ashkenazi Jewish, European (Finnish), Remaining individuals.
Statements
gnomAD v4.1
This variant is present in gnomAD v4.1 (AF= 2.66424e-05; MAF= 0.00266%, 43/1613968 alleles, homozygotes = 0) and has highest observed frequency in the South Asian population (AF= 3.2941e-05; MAF= 0.00329%, 3/91072 alleles, homozygotes = 0); grpmax FAF= 2.314e-05.
gnomAD v2.1
This variant is present in gnomAD v2.1 (AF= 2.83968e-05; MAF= 0.00284%, 8/281722 alleles, homozygotes = 0) and has highest observed frequency in the East Asian population (AF= 5.01354e-05; MAF= 0.00501%, 1/19946 alleles, homozygotes = 0); grpmax FAF= 5.239e-05.
gnomAD-Canada
Absent from gnomAD-Canada v1.0.
SpliceAI and Pangolin
SpliceAI acceptor lossat +17 bp
0.021
SpliceAI acceptor gainat -99 bp
0.001
SpliceAI donor lossat -312 bp
0.066
SpliceAI donor gainat -227 bp
0.002
Pangolin splice lossmagnitude shown
-0.025
Pangolin splice gain
0.001
Other predictors
REVEL
0.804
BayesDel
0.398
How the predictions were used
PP3ModerateMet (moderate): REVEL score 0.804 falls in the ClinGen-calibrated Pathogenic Moderate band (>=0.773).
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Reasoning
NM_032043.3:c.2593C>T (p.Arg865Trp) is a missense variant. No governing VCEP/CSPEC is available for BRIP1 (cspec.found=false; vcep_materials.final_classification_framework.found=false, framework falls back to generic ACMG/AMP 2015), and no gene-specific PP3/BP4 lookup spreadsheet was provided, so the generic calibrated in-silico approach applies. REVEL score = 0.804, which falls within the ClinGen SVI (Pejaver et al. 2022, PMID 36413997) calibrated 'Pathogenic Moderate' band (REVEL >= 0.773) for missense in-silico evidence, supporting PP3 at moderate strength. BayesDel score (0.398139) was also computed but is not used to support or contradict this call: no verified published calibration threshold/PMID for BayesDel is available to this pipeline, so per policy it is treated as not_available regardless of the raw score. SpliceAI predicts no meaningful splice disruption (max delta score = 0.066, well below any splice-altering threshold), so the splice-impact path is silent/non-contributory here (neither supports nor conflicts with the missense PP3 call) and is not itself sufficient to invoke PP3 via splicing. Align-GVGD/HCI prior data were not available for this variant (hci_prior.found=false).
Rule
REVEL >= 0.773 (ClinGen SVI Pejaver 2022 calibration, PMID 36413997) => PP3_Moderate for missense variant with no applicable VCEP override
Evidence considered
REVEL score = 0.804 for NM_032043.3:c.2593C>T (source_registry key 'revel'), meeting the ClinGen SVI calibrated Pathogenic-Moderate threshold (REVEL >= 0.773) from Pejaver et al. 2022, PMID 36413997.
SpliceAI predicts no significant splice impact (max delta score = 0.066; DS_AG=0.001, DS_AL=0.021, DS_DG=0.002, DS_DL=0.066), indicating the splice-loss pathway is not activated and does not itself drive PP3.
No CSPEC/VCEP-specific PP3/BP4 lookup spreadsheet exists for BRIP1 in this case (vcep_materials.json: files_found=[], summaries={}), so generic ACMG calibrated thresholds were applied.
BayesDel score (0.398139) was retrieved but withheld from criterion determination because no verified published calibration threshold/PMID for BayesDel is available to this pipeline.
Still missing
aGVGD/HCI-prior score not available for this variant
No BRIP1-specific VCEP PP3/BP4 lookup table exists to confirm or override the generic REVEL-based call
BayesDel score exists but cannot be used due to lack of a citable calibrated publication/threshold in this pipeline
Sources
revel
BP4Not met: REVEL 0.804 falls in the pathogenic direction, so no benign in-silico evidence applies.
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Reasoning
The calibrated missense in-silico predictor (REVEL = 0.804) falls in the Pathogenic-Moderate range per ClinGen SVI calibration (PMID 36413997), i.e. in the pathogenic direction, not the benign direction, so BP4 cannot be applied for the missense path. SpliceAI shows no splice disruption (max delta = 0.066), which is simply an absence of a splicing signal for this missense variant rather than an independent benign in-silico protein-effect prediction, and is not sufficient on its own to invoke BP4 for a missense variant already showing a pathogenic-direction missense score. No VCEP-specific PP3/BP4 lookup override exists for BRIP1 to redirect this call.
Rule
REVEL >= 0.773 excludes BP4 under the missense in-silico path; SpliceAI absence-of-effect alone is insufficient for BP4 in a missense variant already carrying a pathogenic-direction predictor score
Evidence considered
REVEL score = 0.804 places the variant in the pathogenic-direction (Moderate) calibrated band per Pejaver et al. 2022 (PMID 36413997), precluding a benign-direction BP4 call from the missense path.
SpliceAI predicts no significant splice impact (max delta score = 0.066), which is neutral for the missense in-silico path and not used to independently invoke BP4.
Still missing
No BRIP1-specific VCEP PP3/BP4 lookup table exists to confirm or override this generic determination
BP7N/ANot applicable: this is a missense substitution, not a synonymous variant.
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_032043.3:c.2593C>T in BRIP1 is a missense substitution predicted to produce NP_114432.2:p.(Arg865Trp). 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: missense (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 = 0.07). REVEL score = 0.804. BayesDel score = 0.398139.
7 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
Rare BRIP1 Missense Alleles Confer Risk for Ovarian and Breast Cancer.
Moyer CL et al. · 2020
Functional study characterizing 20 rare/novel BRIP1 missense variants in the helicase domain (aa 1-888) using CRISPR-edited and transient-rescue HeLa/HEK293TN cell models challenged with ICL-damaging agents (MMC, cisplatin). 6/20 alleles were classified null, 9/20 hypomorphic, and 5/20 wildtype-like based on ICL sensitivity, karyotype, cell-cycle, and protein-stability assays. Establishes that BRIP1 missense variants in this domain can be pathogenic loss-of-function or hypomorphic alleles, not merely benign polymorphisms, and that the domain as a whole (aa 1-888) contains a functional mixture of deleterious and neutral variants rather than being uniformly critical. Codon 865 itself (p.Arg865Trp, this case's variant) is not specifically studied, mentioned, or functionally tested in this paper.
The majority of rare alleles (54-of-64) clustered within the highly conserved helicase domain (1-888 amino acids) and are predicted in silico to be deleterious to protein function... A subset of the missense variants identified fall within the seven highly conserved motifs of a DEAH helicase, but most lie outside of these domains.
Results section, paragraph on 'Increased number of BRIP1 missense allele carriers in ovarian and early onset breast cancer cohorts'
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.
This ACMG/AMP standards document defines the generic de novo evidence requirements used because no BRIP1 VCEP/CSPEC was retrieved. It distinguishes PS2, which requires biological parentage confirmation, from PM6, which may apply when parentage is assumed but unconfirmed.
A variant observed to have arisen de novo (parental samples test negative), is considered strong support for pathogenicity if the following conditions are met: Both parental samples were shown through identity testing to be the biological parents of the patient. Note: PM6 applies if identity is assumed but not confirmed.
Section 'PS2 PM6 De novo variants'.
A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders.
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer in women: U.S. Preventive Services Task Force recommendation statement.
The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.
gnomAD v4.1
This variant is present in gnomAD v4.1 (AF= 2.66424e-05; MAF= 0.00266%, 43/1613968 alleles, homozygotes = 0) and has highest observed frequency in the South Asian population (AF= 3.2941e-05; MAF= 0.00329%, 3/91072 alleles, homozygotes = 0); grpmax FAF= 2.314e-05.
gnomAD v2.1
This variant is present in gnomAD v2.1 (AF= 2.83968e-05; MAF= 0.00284%, 8/281722 alleles, homozygotes = 0) and has highest observed frequency in the East Asian population (AF= 5.01354e-05; MAF= 0.00501%, 1/19946 alleles, homozygotes = 0); grpmax FAF= 5.239e-05.
gnomAD-Canada
Absent from gnomAD-Canada v1.0.
ClinVar
This variant has been reported in ClinVar as Uncertain significance (15 clinical laboratories). (ClinVarID = 230320)
In silico
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.07). REVEL score = 0.804. BayesDel score = 0.398139.
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 previously been reported in somatic cancers (COSMIC; COSV51997487, n = 5 times).
Cancer Hotspots
This variant does not lie in a statistically significant hotspot.
This variant was interpreted by pipeline 7.1.0.
The current version is 11.0.07.
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