Hereditary leiomyomatosis and renal cell cancer
diseaseOn this page
Also known as familial leiomyomatosisfamilial leiomyomatosis and renal cell cancerfamilial leiomyomatosis cutis et uterifamilial leiomyomatosis with renal carcinomafamilial multiple cutaneous leiomyomashereditary leiomyomatosishereditary leiomyomatosis and renal cell cancer syndromeHereditary Leiomyomatosis and Renal Cell Carcinomahereditary leiomyomatosis with renal carcinomahereditary multiple cutaneous leiomyomasHLRCCleiomyomatosis and renal cell cancerleiomyomatosis familialLRCCMCULmultiple cutaneous and uterine leiomyomasmultiple cutaneous and uterine leiomyomatamultiple cutaneous leiomyomataReed syndrome
Summary
Hereditary leiomyomatosis and renal cell cancer (MONDO:0007888) is a cancer caused by FH (GenCC Definitive), with 3 cohort genes (2 CIViC-evidence somatic drivers; 566 ClinVar predisposition records) and 8 clinical trials. Top therapeutic interventions include botulinum toxin type a, sodium fluoride f 18, and vandetanib.
At a glance
- Classification: Cancer
- Prevalence: Unknown (Worldwide) [Orphanet-validated]
- Causal gene: FH (GenCC Definitive)
- Cohort genes: 3
- ClinVar variants: 566
- Phenotypes (HPO): 11
- Clinical trials: 8
Clinical features
Epidemiology
Prevalence records
1 prevalence record(s), Orphanet:
| Type | Class | Value | Geography | Validation |
|---|---|---|---|---|
| Cases/families | 200 | Worldwide | Validated |
Signs & symptoms
Clinical features (HPO)
11 HPO clinical features (Orphanet curated; top 11 by frequency):
| HPO ID | Term | Frequency |
|---|---|---|
| HP:0003011 | Abnormality of the musculature | Very frequent (80-99%) |
| HP:0007437 | Multiple cutaneous leiomyomas | Very frequent (80-99%) |
| HP:0007620 | Cutaneous leiomyoma | Very frequent (80-99%) |
| HP:0000989 | Pruritus | Frequent (30-79%) |
| HP:0000131 | Uterine leiomyoma | Occasional (5-29%) |
| HP:0000518 | Cataract | Occasional (5-29%) |
| HP:0002891 | Uterine leiomyosarcoma | Occasional (5-29%) |
| HP:0006732 | Papillary renal cell carcinoma type 2 | Occasional (5-29%) |
| HP:0100580 | Barrett esophagus | Occasional (5-29%) |
| HP:0100650 | Vaginal neoplasm | Occasional (5-29%) |
| HP:0100751 | Esophageal neoplasm | Occasional (5-29%) |
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | hereditary leiomyomatosis and renal cell cancer |
| Mondo ID | MONDO:0007888 |
| MeSH | C535516 |
| OMIM | 150800 |
| Orphanet | 523 |
| ICD-11 | 754002573 |
| NCIT | C51302 |
| UMLS | C1708350 |
| MedGen | 353771 |
| GARD | 0010096 |
| NORD | 1231 |
| Is cancer (heuristic) | yes |
Also known as: familial leiomyomatosis · familial leiomyomatosis and renal cell cancer · familial leiomyomatosis cutis et uteri · familial leiomyomatosis with renal carcinoma · familial multiple cutaneous leiomyomas · hereditary leiomyomatosis · hereditary leiomyomatosis and renal cell cancer · hereditary leiomyomatosis and renal cell cancer syndrome · Hereditary Leiomyomatosis and Renal Cell Carcinoma · hereditary leiomyomatosis and renal cell carcinoma · hereditary leiomyomatosis with renal carcinoma · hereditary multiple cutaneous leiomyomas · HLRCC · leiomyomatosis and renal cell cancer · leiomyomatosis familial · LRCC · MCUL · multiple cutaneous and uterine leiomyomas · multiple cutaneous and uterine leiomyomata · multiple cutaneous leiomyomata (+2 more)
Data availability: 566 ClinVar variants · 8 GenCC gene-disease records · 6 cell lines.
Disease family
Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary disease › hereditary neoplastic syndrome › hereditary leiomyomatosis and renal cell cancer
Related subtypes (116): mosaic variegated aneuploidy syndrome, tuberous sclerosis, hereditary breast ovarian cancer syndrome, hereditary multiple osteochondromas, nevoid basal cell carcinoma syndrome, leukemia, chronic lymphocytic, susceptibility to, 2, blue rubber bleb nevus, cherubism, Beckwith-Wiedemann syndrome, multiple self-healing squamous epithelioma, erythroleukemia, familial, susceptibility to, goiter, multinodular 1, with or without Sertoli-Leydig cell tumors, hyperparathyroidism 2 with jaw tumors, Kaposi sarcoma, susceptibility to, susceptibility to uveal melanoma, melanoma and neural system tumor syndrome, nasopharyngeal carcinoma, susceptibility to, 2, WAGR syndrome, neuroblastoma, susceptibility to, 1, Rothmund-Thomson syndrome, mismatch repair cancer syndrome 1, Wiskott-Aldrich syndrome, N syndrome, hereditary thrombocytopenia and hematologic cancer predisposition syndrome, prostate cancer/brain cancer susceptibility, Brooke-Spiegler syndrome, pancreatic cancer, susceptibility to, 1, Carney-Stratakis syndrome, nasopharyngeal carcinoma, susceptibility to, 1, ovarian cancer, susceptibility to, 1, colorectal cancer, susceptibility to, 1, lung cancer susceptibility 1, leukemia, chronic lymphocytic, susceptibility to, 1, Kostmann syndrome, colorectal cancer, susceptibility to, 2, colorectal cancer, susceptibility to, 3, colorectal cancer, susceptibility to, 5, colorectal cancer, susceptibility to, 6, colorectal cancer, susceptibility to, 7, leukemia, chronic lymphocytic, susceptibility to, 3, leukemia, chronic lymphocytic, susceptibility to, 4, leukemia, chronic lymphocytic, susceptibility to, 5, lung cancer susceptibility 3, colorectal cancer, susceptibility to, 8, colorectal cancer, susceptibility to, 9, colorectal cancer, susceptibility to, 10, colorectal cancer, susceptibility to, 11, lung cancer susceptibility 4, neuroblastoma, susceptibility to, 3, neuroblastoma, susceptibility to, 4, neuroblastoma, susceptibility to, 5, neuroblastoma, susceptibility to, 6, leukemia, acute lymphocytic, susceptibility to, 1, leukemia, acute lymphocytic, susceptibility to, 2, lung cancer susceptibility 5, BAP1-related tumor predisposition syndrome, familial cutaneous telangiectasia and oropharyngeal predisposition cancer syndrome, Maffucci syndrome, basal cell carcinoma, susceptibility to, 7, colorectal cancer, susceptibility to, 12, leukemia, acute lymphoblastic, susceptibility to, 3, cholangiocarcinoma, susceptibility to, progeroid features-hepatocellular carcinoma predisposition syndrome, neuroblastoma, susceptibility to, 7, DDX41-related hematologic malignancy predisposition syndrome, nasopharyngeal carcinoma, susceptibility to, 3, familial isolated hyperparathyroidism, intestinal polyposis syndrome, dyskeratosis congenita, familial rhabdoid tumor, multiple endocrine neoplasia, hereditary pheochromocytoma-paraganglioma, PTEN hamartoma tumor syndrome, familial multiple fibrofolliculoma, hereditary retinoblastoma, familial atypical multiple mole melanoma syndrome, hereditary nonpolyposis colon cancer, Li-Fraumeni syndrome, Cobb syndrome, neurofibromatosis, susceptibility to familial cutaneous melanoma, pancreatic cancer, susceptibility to, 5, leukemia, acute myeloid, susceptibility to, diffuse gastric and lobular breast cancer syndrome with or without cleft lip and/or palate, glioma susceptibility, hemangioma, capillary infantile, susceptibility to, CDH1-related diffuse gastric and lobular breast cancer syndrome, NTHL1-deficiency tumor predisposition syndrome, SAMD9-related spectrum and myeloid neoplasm risk, neuroblastoma, susceptibility to, 2, BARD1-related cancer predisposition, BRCA1-related cancer predisposition, BRCA2-related cancer predisposition, ATM-related cancer predisposition, CHEK2-related cancer predisposition, PALB2-related cancer predisposition, RAD51C-related cancer predisposition, RAD51D-related cancer predisposition, Li-fraumeni-like syndrome, breast cancer, familial, susceptibility to, 1, breast cancer, familial, susceptibility to, 2, breast cancer, familial, susceptibility to, 3, colorectal cancer, susceptibility to, 4, colorectal cancer, susceptibility to, on chromosome 15, ovarian cancer, familial, susceptibility to, 1, ovarian cancer, familial, susceptibility to, 2, ovarian cancer, familial, susceptibility to, 3, inherited hematologic cancer-predisposing syndrome, mosaic neurofibromatosis/schwannomatosis, tumor predisposition syndrome 2, prostate cancer, hereditary, X-linked 3, follicular lymphoma, susceptibility to, GPR161-related medulloblastoma predisposition, SAMD9L-related spectrum and myeloid neoplasm risk, HAVCR2-related cancer predisposition, EGLN1-related erythrocytosis and pheochromocytoma/paraganglioma predisposition
Genetics & variants
GWAS landscape
No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.
Variant details and genetic-evidence tiers
ClinVar germline variants
566 retrieved; paginated sample, class counts are floors:
186 benign/likely benign, 108 conflicting classifications of pathogenicity, 65 pathogenic/likely pathogenic, 62 pathogenic, 50 likely benign, 48 uncertain significance, 30 benign, 17 likely pathogenic
| ClinVar | Variant (HGVS) | Gene | Classification | Review |
|---|---|---|---|---|
| 1066054 | NM_000143.4(FH):c.563A>T (p.Asn188Ile) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 1384577 | NM_000143.4(FH):c.822dup (p.Gly275fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 1387156 | NM_000143.4(FH):c.1478del (p.Thr493fs) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 141355 | NM_000143.4(FH):c.697C>T (p.Arg233Cys) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 142654 | NM_000143.4(FH):c.557G>A (p.Ser186Asn) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 1455272 | NM_000143.4(FH):c.1247del (p.Val416fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 16232 | NM_000143.4(FH):c.301C>T (p.Arg101Ter) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 16234 | NM_000143.4(FH):c.671_672del (p.Glu224fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 16235 | NM_000143.4(FH):c.1027C>T (p.Arg343Ter) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 16236 | NM_000143.4(FH):c.698G>A (p.Arg233His) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 16237 | NM_000143.4(FH):c.698G>T (p.Arg233Leu) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 167066 | NM_000143.4(FH):c.1067T>A (p.Leu356Ter) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 1691284 | NM_000143.4(FH):c.936T>G (p.Phe312Leu) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 1757309 | NM_000143.4(FH):c.712G>C (p.Asp238His) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 1765675 | NM_000143.4(FH):c.907_910del (p.Pro304fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 184555 | NM_000143.4(FH):c.700A>G (p.Thr234Ala) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 185496 | NM_000143.4(FH):c.786_806del (p.Lys263_Ile269del) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 186284 | NM_000143.4(FH):c.404A>G (p.His135Arg) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 198391 | NM_000143.4(FH):c.912_918del (p.Phe305fs) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 208374 | NM_000143.4(FH):c.905-1G>A | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 208375 | NM_000143.4(FH):c.1210G>T (p.Glu404Ter) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 214373 | NM_000143.4(FH):c.584T>C (p.Met195Thr) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 214374 | NM_000143.4(FH):c.1093A>G (p.Ser365Gly) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 214389 | NM_000143.4(FH):c.139C>T (p.Gln47Ter) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 214399 | NM_000143.4(FH):c.1083_1086del (p.Glu362fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 214405 | NM_000143.4(FH):c.1370_1371insTCAC (p.Ala458fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 214406 | NM_000143.4(FH):c.1400dup (p.Ala468fs) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 214408 | NM_000143.4(FH):c.395_399del (p.Lys131_Leu132insTer) | FH | Pathogenic | criteria provided, multiple submitters, no conflicts |
| 214412 | NM_000143.4(FH):c.904+1G>A | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
| 214413 | NM_000143.4(FH):c.934T>C (p.Phe312Leu) | FH | Pathogenic/Likely pathogenic | criteria provided, multiple submitters, no conflicts |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 16 · Orphanet: 12 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
Somatic driver evidence (intOGen + CIViC, cohort fanout)
| Gene | intOGen role | Cancer types | CIViC |
|---|---|---|---|
| FH | CIViC #1892 | ||
| PTCH1 | LoF | ANGS,BCC,CHOL,ESCA,MBL,NPC,OS,PAST,PLMESO,SKIN,WDTC | CIViC #4645 |
GenCC gene–disease validity (cohort genes)
the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.
| Gene | Classification | Inheritance | Disease | Records |
|---|---|---|---|---|
| FH | Definitive | Autosomal dominant | hereditary leiomyomatosis and renal cell cancer | 16 |
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| FH | Orphanet:24 | Fumaric aciduria |
| FH | Orphanet:29072 | Hereditary pheochromocytoma-paraganglioma |
| FH | Orphanet:523 | Hereditary leiomyomatosis and renal cell cancer |
| PTCH1 | Orphanet:220386 | Semilobar holoprosencephaly |
| PTCH1 | Orphanet:2353 | Schilbach-Rott syndrome |
| PTCH1 | Orphanet:280195 | Septopreoptic holoprosencephaly |
| PTCH1 | Orphanet:280200 | Microform holoprosencephaly |
| PTCH1 | Orphanet:377 | Gorlin syndrome |
| PTCH1 | Orphanet:77301 | Monosomy 9q22.3 syndrome |
| PTCH1 | Orphanet:93924 | Lobar holoprosencephaly |
| PTCH1 | Orphanet:93925 | Alobar holoprosencephaly |
| PTCH1 | Orphanet:93926 | Midline interhemispheric variant of holoprosencephaly |
Cohort genes → proteins
3 cohort genes, 3 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| multi_evidence | 3 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| FH | HGNC:3700 | ENSG00000091483 | P07954 | Fumarate hydratase, mitochondrial | gencc,clinvar |
| PLD5 | HGNC:26879 | ENSG00000180287 | Q8N7P1 | Inactive phospholipase D5 | clinvar |
| PTCH1 | HGNC:9585 | ENSG00000185920 | Q13635 | Protein patched homolog 1 | clinvar |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| FH | Fumarate hydratase, mitochondrial | Catalyzes the reversible stereospecific interconversion of fumarate to L-malate. |
| PTCH1 | Protein patched homolog 1 | Acts as a receptor for sonic hedgehog (SHH), indian hedgehog (IHH) and desert hedgehog (DHH). |
Protein-family classification
Druggable: 1 · Difficult: 0 · Unknown: 2 · Druggable fraction: 0.33
Family distribution
Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.
| Family | Genes | Fold | FDR |
|---|---|---|---|
| Enzyme (other) | 1 | 4.0× | 0.460 |
| Other/Unknown | 2 | 1.2× | 0.587 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| FH | Enzyme (other) | yes | 4.2.1.2 | Fumarate_lyase_fam, Fum_hydII, L-Aspartase-like |
| PLD5 | Other/Unknown | no | PLipase_D/transphosphatidylase, PLDc_3, Diverse_PLD-related | |
| PTCH1 | Other/Unknown | no | SSD, TM_rcpt_patched, HMGCR/SNAP/NPC1-like_SSD |
Expression context
Cohort genes with no expression data: 0.
3 cohort genes are a single-cell marker in ≥1 SCXA experiment.
Breadth distribution (Bgee present_calls)
| Bucket | Genes |
|---|---|
| narrow (1-5 tissues) | 0 |
| moderate (6-20) | 0 |
| broad (>20) | 3 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| body of tongue | 1 |
| cardiac ventricle | 1 |
| heart right ventricle | 1 |
| descending thoracic aorta | 1 |
| pigmented layer of retina | 1 |
| thoracic aorta | 1 |
| dorsal root ganglion | 1 |
| tibia | 1 |
| trigeminal ganglion | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| FH | 292 | ubiquitous | marker | heart right ventricle, body of tongue, cardiac ventricle |
| PLD5 | 167 | broad | marker | pigmented layer of retina, descending thoracic aorta, thoracic aorta |
| PTCH1 | 275 | ubiquitous | marker | tibia, dorsal root ganglion, trigeminal ganglion |
Protein interactions among cohort
Intra-cohort edges: 0.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| FH | 3,709 |
| PTCH1 | 3,368 |
| PLD5 | 640 |
Structural data
PDB: 2 · AlphaFold-only: 1 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| PTCH1 | Q13635 | 16 |
| FH | P07954 | 7 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| PLD5 | Q8N7P1 | 83.26 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 8. Enrichment computed across 3 evidence-associated genes (2 with Reactome annotation).
Pathways by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| GLI proteins bind promoters of Hh responsive genes to promote transcription | 1 | 815.7× | 0.006 | PTCH1 |
| Ligand-receptor interactions | 1 | 713.8× | 0.006 | PTCH1 |
| Activation of SMO | 1 | 317.2× | 0.008 | PTCH1 |
| Citric acid cycle (TCA cycle) | 1 | 211.5× | 0.009 | FH |
| Class B/2 (Secretin family receptors) | 1 | 95.2× | 0.014 | PTCH1 |
| Hedgehog ‘off’ state | 1 | 89.2× | 0.014 | PTCH1 |
| Hedgehog ‘on’ state | 1 | 79.3× | 0.014 | PTCH1 |
| Mitochondrial protein degradation | 1 | 57.1× | 0.017 | FH |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 2 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| fumarate metabolic process | 1 | 8426.0× | 0.003 | FH |
| obsolete regulation of arginine metabolic process | 1 | 4213.0× | 0.003 | FH |
| response to chlorate | 1 | 4213.0× | 0.003 | PTCH1 |
| neural plate axis specification | 1 | 4213.0× | 0.003 | PTCH1 |
| cell proliferation involved in metanephros development | 1 | 4213.0× | 0.003 | PTCH1 |
| cell differentiation involved in kidney development | 1 | 2808.7× | 0.004 | PTCH1 |
| epidermal cell fate specification | 1 | 1685.2× | 0.005 | PTCH1 |
| neural tube patterning | 1 | 1404.3× | 0.005 | PTCH1 |
| hindlimb morphogenesis | 1 | 1404.3× | 0.005 | PTCH1 |
| arginine metabolic process | 1 | 1203.7× | 0.005 | FH |
| negative regulation of cell division | 1 | 1203.7× | 0.005 | PTCH1 |
| mammary gland duct morphogenesis | 1 | 1203.7× | 0.005 | PTCH1 |
| positive regulation of epidermal cell differentiation | 1 | 1053.2× | 0.005 | PTCH1 |
| malate metabolic process | 1 | 936.2× | 0.005 | FH |
| metanephric collecting duct development | 1 | 842.6× | 0.005 | PTCH1 |
| response to alkaloid | 1 | 766.0× | 0.005 | PTCH1 |
| prostate gland development | 1 | 702.2× | 0.005 | PTCH1 |
| urea cycle | 1 | 648.1× | 0.005 | FH |
| mammary gland epithelial cell differentiation | 1 | 601.9× | 0.005 | PTCH1 |
| negative regulation of multicellular organism growth | 1 | 561.7× | 0.005 | PTCH1 |
| somite development | 1 | 561.7× | 0.005 | PTCH1 |
| limb morphogenesis | 1 | 526.6× | 0.005 | PTCH1 |
| smooth muscle tissue development | 1 | 526.6× | 0.005 | PTCH1 |
| commissural neuron axon guidance | 1 | 495.6× | 0.005 | PTCH1 |
| positive regulation of double-strand break repair via nonhomologous end joining | 1 | 495.6× | 0.005 | FH |
| cell fate determination | 1 | 468.1× | 0.005 | PTCH1 |
| spinal cord motor neuron differentiation | 1 | 468.1× | 0.005 | PTCH1 |
| cellular response to cholesterol | 1 | 421.3× | 0.005 | PTCH1 |
| negative regulation of stem cell proliferation | 1 | 421.3× | 0.005 | PTCH1 |
| dorsal/ventral neural tube patterning | 1 | 401.2× | 0.005 | PTCH1 |
Therapeutics
Drug target analysis
Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 3
Druggability breadth: 2 of 3 evidence-associated genes (67%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| FH | 0 | 0 |
| PLD5 | 0 | 0 |
| PTCH1 | 0 | 0 |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 1.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| PTCH1 | 4 | Binding:4 |
| FH | 1 | Binding:1 |
Cohort enzymes (BRENDA EC)
| Symbol | EC numbers | Names |
|---|---|---|
| FH | 4.2.1.2 | fumarate hydratase |
Pharmacogenomics
Cohort genes with a PharmGKB record: 3; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Drug repurposing candidates
0 approved/phased drugs hit cohort targets but don’t yet appear in disease-level clinical trials. Target-inhibition rationale is strongest for cancer driver genes; a bioactivity hit is a screening signal, not a treatment claim.
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 0 | |
| B | Phased (≥1) drug, not yet approved | 0 | |
| C | Druggable family + PDB, no drug | 1 | FH |
| D | Druggable family + AlphaFold only, no drug | 0 | |
| E | Difficult family or no structure, no drug | 2 | PLD5, PTCH1 |
Undrugged target profiles
3 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| FH | 1 | — |
| PLD5 | 0 | — |
| PTCH1 | 4 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 8.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| PHASE2 | 4 |
| Not specified | 3 |
| PHASE1/PHASE2 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT04981509 | PHASE2 | RECRUITING | Testing of Bevacizumab, Erlotinib, and Atezolizumab in Combination for Advanced-Stage Kidney Cancer |
| NCT00971620 | PHASE2 | COMPLETED | Randomized Pilot Study for the Treatment of Cutaneous Leiomyomas With Botulinum Toxin |
| NCT01130519 | PHASE2 | COMPLETED | A Phase II Study of Bevacizumab and Erlotinib in Subjects With Advanced Hereditary Leiomyomatosis and Renal Cell Cancer (HLRCC) or Sporadic Papillary Renal Cell Cancer |
| NCT02495103 | PHASE1/PHASE2 | TERMINATED | Vandetanib in Combination With Metformin in People With HLRCC or SDH-Associated Kidney Cancer or Sporadic Papillary Renal Cell Carcinoma |
| NCT04603365 | PHASE2 | WITHDRAWN | Pamiparib and Temozolomide for the Treatment of Hereditary Leiomyomatosis and Renal Cell Cancer |
| NCT03749980 | Not specified | RECRUITING | MyVHL: Patient Natural History Study |
| NCT04623502 | Not specified | RECRUITING | An Investigation of Kidney and Urothelial Tumor Metabolism in Patients Undergoing Surgical Resection and/or Biopsy |
| NCT05534854 | Not specified | UNKNOWN | Frequency, Clinical Phenotype and Genetic Analysis of Heritable Kidney Cancer Syndromes |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| BOTULINUM TOXIN TYPE A | 4 | 1 |
| SODIUM FLUORIDE F 18 | 4 | 1 |
| VANDETANIB | 4 | 1 |
| PAMIPARIB | 3 | 1 |
| CHEMBL3919533 | 0 | 1 |
Related Atlas pages
- Cohort genes: FH, PTCH1, PLD5
- Drugs: Botulinum Toxin Type A, SODIUM FLUORIDE F 18, Vandetanib, Pamiparib