475: A Cell Line Fitness Score Predicts Cancer Risk in Li-Fraumeni Syndrome
9 min
Penkert J et al., The American Journal of Human Genetics - Carriers of disease-causing TP53 variants range from mild to severe cancer phenotypes. Using relative fitness scores from a deep CRISPR mutagenesis screen of 9,225 TP53 mutations, this registry study of 437 individuals from 168 families shows that variants scoring 0.673 or higher go with earlier cancer and with full Li-Fraumeni syndrome. Key terms: Li-Fraumeni syndrome, TP53, deep CRISPR mutagenesis, relative fitness score, cancer surveillance. Study Highlights: A previous screen introduced 9,225 TP53 mutations into a colorectal cancer cell line and scored how well each mutant survived TP53 activators, giving a relative fitness score (RFS). The authors linked these scores to 437 individuals from 168 families in the German Cancer Predisposition Syndrome Registry. Carriers of variants with an RFS of 0.673 or higher developed cancer earlier; an RFS below 0.673 had a hazard ratio of 0.41 (95% CI 0.25 to 0.66, p 0.0002) for cancer. The association held among the 407 individuals whose variant is predicted to produce an altered protein, excluding NULL variants (hazard ratio 0.43). Families with a high score met the definition of Li-Fraumeni syndrome in 110 of 148 cases (74.3%), against 3 of 20 (15%) with a low score. Conclusion: Relative fitness scores from deep CRISPR mutagenesis separated TP53 variant carriers with earlier cancer and more severe Li-Fraumeni spectrum phenotypes, which suggests they could feed future variant classification and tailored surveillance. The finding was not validated in an independent cohort, the scores come from a single colorectal cell line, and they exist only for variants in the DNA binding domain. Article title: Deep CRISPR mutagenesis predicts cancer risk in Li-Fraumeni syndrome First author: Penkert J Journal: The American Journal of Human Genetics DOI: 10.1016/j.ajhg.2026.09.016 Reference: Penkert J., Großhennig A., Dutzmann C.M., Ewert A., Zimmer R., Schoene-Bake...