Germline variation in TP53 regulatory network genes associates with breast cancer survival and treatment outcome.

Germline variation in the TP53 network genes PRKAG2, PPP2R2B, CCNG1, PIAS1 and YWHAQ was previously suggested to have an impact on drug response in vitro. Here, we investigated the effect on breast cancer survival of germline variation in these genes in 925 Finnish breast cancer patients and further analyzed five single nucleotide polymorphisms (SNPs) in PRKAG2 (rs1029946, rs4726050, rs6464153, rs7789699) and PPP2R2B (rs10477313) for 10-year survival in breast cancer patients, interaction with TP53 R72P and MDM2-SNP309, outcome after specific adjuvant therapy and correlation to tumor characteristics in 4,701 invasive cases from four data sets. We found evidence for carriers of PRKAG2-rs1029946 and PRKAG2-rs4726050 having improved survival in the pooled data (HR 0.53, 95% CI 0.3-0.9; p = 0.023 for homozygous carriers of the rare G-allele and HR 0.85, 95% CI 0.7-0.9; p = 0.049 for carriers of the rare G allele, respectively). PRKAG2-rs4726050 showed a significant interaction with MDM2-SNP309, with PRKAG2-rs4726050 rare G-allele having a dose-dependent effect for better breast cancer survival confined only to MDM2 SNP309 rare G-allele carriers (HR 0.45, 95% CI 0.2-0.7; p = 0.001). This interaction also emerged as an independent predictor of better survival (p = 0.047). PPP2R2B-rs10477313 rare A-allele was found to predict better survival (HR 0.82, 95% CI 0.6-0.9; p = 0.018), especially after hormonal therapy (HR 0.66, 95% CI 0.5-0.9; p = 0.048). These findings warrant further studies and suggest that genetic markers in TP53 network genes such as PRKAG2 and PPP2R2B might affect prognosis and treatment outcome in breast cancer patients.

Association tests for rare and common variants based on genotypic and phenotypic measures of similarity between individuals.

Genome-wide association studies have helped us identify thousands of common variants associated with several widespread complex diseases. However, for most traits, these variants account for only a small fraction of phenotypic variance or heritability. Next-generation sequencing technologies are being used to identify additional rare variants hypothesized to have higher effect sizes than the already identified common variants, and to contribute significantly to the fraction of heritability that is still unexplained. Several pooling strategies have been proposed to test the joint association of multiple rare variants, because testing them individually may not be optimal. Within a gene or genomic region, if there are both rare and common variants, testing their joint association may be desirable to determine their synergistic effects. We propose new methods to test the joint association of several rare and common variants with binary and quantitative traits. Our association test for quantitative traits is based on genotypic and phenotypic measures of similarity between pairs of individuals. For the binary trait or case-control samples, we recently proposed an association test based on the genotypic similarity between individuals. Here, we develop a modified version of this test for rare variants. Our tests can be used for samples taken from multiple subpopulations. The power of our test statistics for case-control samples and quantitative traits was evaluated using the GAW17 simulated data sets. Type I error rates for the proposed tests are well controlled. Our tests are able to identify some of the important causal genes in the GAW17 simulated data sets.