Table 3 Actionable germline variants in urothelial carcinoma and potential therapeutic implications.

From: Prevalence of pathogenic germline cancer risk variants in high-risk urothelial carcinoma

Gene(s)

DRG pathway

Prevalence (%)

Germline syndrome/risks

Molecular-specific targeted treatment

MLH1, MSH2, MSH6, PMS2

Mismatch repair

5.9

CNS cancer, colorectal cancer, duodenal cancer, endometrial cancer

Anti-PD1, PD-L1

Monoallelic MUTYH

Other

2

Colorectal cancer

None

CHEK2

HR

2.8

Breast cancer, colorectal cancer

None

APC

None

0.1

Colorectal cancer

None

TP53

None

0.2

Breast cancer, colorectal cancer, melanoma, CNS tumors

None

ATM

HR

1.6

Breast cancer

None

RAD51C/D

HR/Fanconi

0.2

Ovarian cancer

None

PALB2

HR

0.6

Breast cancer, prostate cancer

PARP inhibitors (?)

BRIP1

HR

0.8

Ovarian cancer

None

BRCA1/2

HR

4.4

Breast cancer, ovarian cancer, prostate cancer

PARP inhibitors (?)

  1. CNS central nervous system, DRG damage repair gene, HR homologous recombination.