Guidelines for the Li–Fraumeni and heritable TP53 -related ... | Li fraumeni syndrome genereviews
Fifty years after the recognition of the Li–Fraumeni syndrome (LFS), our perception of cancers related to germline alterations of TP53 has ...SkiptomaincontentThankyouforvisitingnature.com.YouareusingabrowserversionwithlimitedsupportforCSS.Toobtainthebestexperience,werecommendyouuseamoreuptodatebrowser(orturnoffcompatibilitymodeinInternetExplorer).Inthemeantime,toensurecontinuedsupport,wearedisplayingthesitewithoutstylesandJavaScript.AdvertisementnatureeuropeanjournalofhumangeneticsarticlesarticleGuidelinesfortheLi–FraumeniandheritableTP53-relatedcancersyndromesDownloadPDFSubjectsCancerscreeningRiskfactorsAbstractFiftyyearsaftertherecognitionoftheLi–Fraumenisyndrome(LFS),ourperceptionofcancersrelatedtogermlinealterationsofTP53hasdrasticallychanged:(i)germlineTP53alterationsareoftenidentifiedamongchildrenwithcancers,inparticularsoft-tissuesarcomas,adrenocorticalcarcinomas,centralnervoussystemtumours,oramongadultfemaleswithearlybreastcancers,withoutfamilialhistory.ThisjustifiestheexpansionoftheLFSconcepttoawidercancerpredispositionsyndromedesignatedheritableTP53-relatedcancer(hTP53rc)syndrome;(ii)theinterpretationofgermlineTP53variantsremainschallengingandshouldintegrateepidemiological,phenotypical,bioinformaticsprediction,andfunctionaldata;(iii)thepenetranceofgermlinedisease-causingTP53variantsisvariable,dependingbothonthetypeofvariant(dominant-negativevariantsbeingassociatedwithahighercancerrisk)andonmodifyingfactors;(iv)whole-bodyMRI(WBMRI)allowsearlydetectionoftumoursinvariantcarriersand(v)incancerpatientswithgermlinedisease-causingTP53variants,radiotherapy,andconventionalgenotoxicchemotherapycontributetothedevelopmentofsubsequentprimarytumours.ItiscriticaltoperformTP53testingbeforetheinitiationoftreatmentinordertoavoidincarriers,ifpossible,radiotherapyandgenotoxicchemotherapies.Inchildren,therecommendationsaretoperformclinicalexaminationandabdominalultrasoundevery6months,annualWBMRIandbrainMRIfromthefirstyearoflife,iftheTP53variantisknowntobeassociatedwithchildho
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