Germline loss-of-function mutations in PPP2R1B in patients with a personal and family history of cancer

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Abstract

An estimated 5-10% of cancer results from an underlying genetic predisposition, yet for the majority of these cases the genes in question remain unknown, suggesting a critical need to identify new cancer predisposition genes. The protein phosphatase 2A (PP2A) family exists as a trimeric holoenzyme and is a vital negative regulator of multiple oncogenic pathways. PP2A inhibition by somatic mutation, loss of expression, and upregulation of its exogenous inhibitors in tumors has been well described. However, it remains unknown whether germline loss of any PP2A subunits results in a predisposition to cancer in humans. In this study, we identified nine cancer patients with germline loss-of-function (LOF) variants in PPP2R1B (Aβ), the beta isoform of the PP2A scaffold subunit. All four patients for whom documentation was available also had a family history of cancer, including multiple indicators of hereditary cancer. The most highly represented cancer among the Aβ germline patients was breast cancer. Overexpression of these mutant forms of Aβ resulted in truncated proteins that were rapidly turned over. Characterization of an additional missense germline Aβ variant, R233C, that is also recurrently mutated at the somatic level found that it disrupts PP2A catalytic subunit binding resulting in loss of phosphatase activity. An analysis of Aβ expression among multiple breast cancer cohorts revealed that somatic, heterozygous loss of Aβ was a frequent event in this disease and decreased Aβ expression correlated with shorter disease-free and overall survival. Furthermore, Aβ levels were significantly lower in multiple histological subtypes of both in situ and malignant breast cancer compared to adjacent normal breast tissue, suggesting that Aβ loss is an early event in breast cancer development. Together, this highlights a role for Aβ as a predisposition gene in breast cancer and potentially additional cancers.

Authors

Sahar Mazhar, Caitlin M. O’Connor, Alexis Harold, Amanda C. Dowdican, Peter J. Ulintz, Erika N. Hanson, Yuping Zhang, Michelle F. Jacobs, Sofia D. Merajver, Mark W. Jackson, Anthony Scott, Anieta M. Sieuwerts, Arul M. Chinnaiyan, Goutham Narla