# NM_002392.6(MDM2):c.1491C>T (p.Pro497=)

https://sugi.bio/variant/mdm2-p-pro497

## Summary

**MDM2 p.Pro497= (c.1491C>T)** is classified **Likely benign** in MDM2 (ClinVar, Single submitter, 1 submitter; last evaluated 2021-02-13). Very rare (popmax 0.0011%, sas); Associated with Accelerated tumor formation, susceptibility to.

**At a glance:** Likely benign · review: Single submitter · rsID rs757161769 · 1 submitter · 1 linked condition · very rare (popmax 0.0011%, sas)

## For patients & families {#patients}

This is a change in the MDM2 gene that is classified as likely benign — not considered disease-causing, submitted by 1 submitter, and is linked to Accelerated tumor formation, susceptibility to.

*Reference information, not medical advice, and not a prediction for any individual. A genetic counselor or clinician can interpret what it means for you and your family.*

**Support & next steps:** [Find a genetic counselor (NSGC)](https://findageneticcounselor.nsgc.org/).

## Identity {#identity}

| Field | Value |
| --- | --- |
| Gene | [MDM2](https://sugi.bio/atlas/gene/MDM2/) |
| Protein change (HGVS p.) | p.Pro497= |
| Coding change (HGVS c.) | c.1491C>T |
| MANE Select transcript | [NM_002392](https://www.ncbi.nlm.nih.gov/nuccore/NM_002392) |
| dbSNP | [rs757161769](https://www.ncbi.nlm.nih.gov/snp/rs757161769/) |
| Variant type | single nucleotide variant |
| Location | chr12:68839846-68839846 (GRCh38) |
| ClinVar | [VCV1635742](https://www.ncbi.nlm.nih.gov/clinvar/variation/1635742/) |

**All HGVS expressions:** `NC_000012.11:g.69233626C>T`, `NC_000012.12:g.68839846C>T`, `NG_016708.1:g.36656C>T`, `NM_001145337.3:c.1332C>T`, `NM_001145339.2:c.1326C>T`, `NM_001145340.3:c.885C>T`, `NM_001278462.2:c.963C>T`, `NM_001367990.1:c.1473C>T`, `NM_002392.6:c.1491C>T`

## Computational & population evidence {#evidence}

**Concordance:** Mixed / partial computational evidence (see below).

- **Missense predictors (AlphaMissense/REVEL/SaProt) do not apply** to this variant type — they score amino-acid substitutions only. For non-missense variants the computational signal comes from conservation (below), not from a missing predictor score.
- Conservation: phyloP 0.135, GERP 0.788, phastCons 0.782 — weakly conserved position
- CADD: **PHRED 7.235**. No single ClinGen-calibrated threshold exists and the expert panels that use CADD disagree — GUCY2D/AIPL1 require ≥ 20.0 for an untranslated-region variant, ABCA4 ≥ 28.1 for a synonymous or indel variant, the Pulmonary Hypertension panel imports Pejaver 2022's missense-calibrated numbers, and the Antibody Deficiencies panel declines CADD entirely for PIK3CD. CADD v1.7 also incorporates Zoonomia phyloP, so it partly re-expresses the conservation above. *Descriptive; no threshold applied.*
- SpliceAI: **no splice effect predicted**. SpliceAI outputs four numbers per variant, not one: acceptor loss, donor loss, acceptor gain, donor gain (DS_AL / DS_DL / DS_AG / DS_DG). A loss score is an existing splice site weakened or destroyed; a gain score is a new site created or an existing one strengthened. The release publishes its own filter rule, which we read from the dataset rather than assume: an allele is reported only if the largest of its four deltas reaches 0.2. No allele at this position is in the release, so all four are under 0.2 for every alternate allele here. No figure is shown because none was read: the bound is deduced from that absence. It is a result, not a gap in our data, because the release scores every possible substitution across the transcripts it covers (Ensembl MANE v1.4) before it filters, so what survives for a gene is one continuous stretch. What is measured is that this position sits inside the stretch covered for MDM2 (790 scored positions, the nearest 13 bases away); what is taken from the release's own description, rather than measured, is that coverage inside that stretch is continuous. On that, SpliceAI did score it. *ClinGen's SVI treats the largest of the four as evidence against a splicing effect at or below 0.1, where it may support BP4, and as uninformative between 0.1 and 0.2. We cannot tell which applies here, so these SpliceAI data support neither BP4 nor PP3; that is a statement about this evidence alone, not about the variant's other evidence.*
- Population frequency (gnomAD v4.1): grpmax **0.0011%** (sas) · FAF95 6.8e-05% · FAF99 1.9e-05% · 1/91,006 in the highest group · 4/1,613,524 alleles overall — very rare (popmax 0.0011%, sas).

| Ancestry group | Allele frequency | 1 in |
| --- | --- | --- |
| South Asian (grpmax) | 0.0011% | 91,006 |
| European (non-Finnish) | 0.000254% | 393,227 |

*Computational predictors are not independent (ClinGen Variant Classification guidance): AlphaMissense (Cheng et al. 2023) carries the ACMG weight for missense and conservation (phyloP/GERP/phastCons) for non-missense; REVEL (Pejaver-2022 calibrated strength bands) and SaProt (Su et al. 2023, structure-aware, ClinVar-independent protein language model, raw LLR) are shown as orthogonal agreement signals, not additive. For frequency, the gnomAD v4.1 grpmax filtering allele frequency (FAF95) is ClinGen's designated BA1/BS1 input (gnomAD v4 guidance v3.0, June 2025); BA1/BS1 thresholds are disease-specific, not a blanket 5%. Predictions, not a clinical determination.*

## Gene constraint & dosage {#gene-context}

**MDM2** population constraint: LOEUF 0.325, pLI 1, missense-Z 2.585. *Lower LOEUF and higher pLI indicate a gene that tolerates loss-of-function poorly; ClinGen dosage is the curated haploinsufficiency call.*

## Protein context {#protein}


AlphaFold model confidence (whole protein): pLDDT 63.24, 30% of residues very-high.

**148 experimental structure(s)** (PDB): [1RV1](https://www.rcsb.org/structure/1RV1), [1T4E](https://www.rcsb.org/structure/1T4E), [1T4F](https://www.rcsb.org/structure/1T4F), [1YCR](https://www.rcsb.org/structure/1YCR), [1Z1M](https://www.rcsb.org/structure/1Z1M), [22IZ](https://www.rcsb.org/structure/22IZ) — incl. mutant structure 3LNZ.

## What this gene does {#gene-function}

*Describes the biological roles of MDM2 (the gene this variant disrupts) — not effects measured for this specific variant. A damaging variant is expected to affect these functions and pathways; the degree depends on the variant.*

**How this variant is thought to act:** MDM2's established molecular role includes p53 binding. In Reactome, MDM2 is annotated in disease pathway(s) including **Constitutive Signaling by AKT1 E17K in Cancer**, **Signaling by ALK fusions and activated point mutants**.

**Disease mechanism (Reactome):** MDM2 loss or alteration is curated in [Constitutive Signaling by AKT1 E17K in Cancer](https://reactome.org/content/detail/R-HSA-5674400), [Signaling by ALK fusions and activated point mutants](https://reactome.org/content/detail/R-HSA-9725370).

### Pathways affected {#pathways}

MDM2 participates in **16 Reactome pathways** (⚕ = disease pathway):

| Pathway (Reactome) | Evidence |
| --- | --- |
| ⚕ [Constitutive Signaling by AKT1 E17K in Cancer](https://reactome.org/content/detail/R-HSA-5674400) | curated |
| ⚕ [Signaling by ALK fusions and activated point mutants](https://reactome.org/content/detail/R-HSA-9725370) | curated |
| [AKT phosphorylates targets in the cytosol](https://reactome.org/content/detail/R-HSA-198323) | curated |
| [Degradation of CDH1](https://reactome.org/content/detail/R-HSA-9766229) | curated |
| [Oncogene Induced Senescence](https://reactome.org/content/detail/R-HSA-2559585) | curated |
| [Oxidative Stress Induced Senescence](https://reactome.org/content/detail/R-HSA-2559580) | curated |
| [Regulation of RUNX3 expression and activity](https://reactome.org/content/detail/R-HSA-8941858) | curated |
| [Regulation of TP53 Activity through Methylation](https://reactome.org/content/detail/R-HSA-6804760) | curated |
| [Regulation of TP53 Activity through Phosphorylation](https://reactome.org/content/detail/R-HSA-6804756) | curated |
| [Regulation of TP53 Degradation](https://reactome.org/content/detail/R-HSA-6804757) | curated |
| [SUMOylation of transcription factors](https://reactome.org/content/detail/R-HSA-3232118) | curated |
| [SUMOylation of ubiquitinylation proteins](https://reactome.org/content/detail/R-HSA-3232142) | curated |
| [Stabilization of p53](https://reactome.org/content/detail/R-HSA-69541) | curated |
| [Trafficking of AMPA receptors](https://reactome.org/content/detail/R-HSA-399719) | curated |
| [Ub-specific processing proteases](https://reactome.org/content/detail/R-HSA-5689880) | curated |
| [NPAS4 regulates expression of target genes](https://reactome.org/content/detail/R-HSA-9768919) | electronic |

### Molecular function & processes (GO — experimentally supported) {#go}

**Molecular function:** p53 binding, ubiquitin-protein transferase activity, 5S rRNA binding, zinc ion binding, ligase activity, SUMO transferase activity.

**Biological process:** negative regulation of transcription by RNA polymerase II, ubiquitin-dependent protein catabolic process, apoptotic process, protein ubiquitination, DNA damage response, signal transduction by p53 class mediator, protein destabilization.

## Clinical significance {#significance}

**Likely benign** — review status Single submitter *(criteria provided, single submitter)*, last evaluated 2021-02-13.

**Submitter consensus:** unanimous (1/1 Likely benign).

### Submitter classifications {#submitters}

| Submitter | Classification | Review | Method | Date |
| --- | --- | --- | --- | --- |
| Labcorp Genetics (formerly Invitae), Labcorp | Likely benign | criteria provided, single submitter | clinical testing | 2021-02-13 |

## Associated conditions {#conditions}

[Accelerated tumor formation, susceptibility to](https://sugi.bio/atlas/disease/accelerated-tumor-formation-susceptibility-to/).

**Reported phenotype names (ClinVar):** Accelerated tumor formation, susceptibility to.

## Similar variants {#similar}

Related MDM2 variant pages (same residue, condition, or type): [MDM2 c.523+5A>G](/variant/mdm2-c-523-plus-5a-g), [MDM2 p.Arg332His](/variant/mdm2-p-arg332his), [MDM2 p.Asn117Ser](/variant/mdm2-p-asn117ser), [MDM2 p.Asn374Ser](/variant/mdm2-p-asn374ser), [MDM2 p.Gln414Leu](/variant/mdm2-p-gln414leu), [MDM2 p.Glu273Ala](/variant/mdm2-p-glu273ala), [MDM2 p.Gly341Glu](/variant/mdm2-p-gly341glu), [MDM2 p.Ser122Leu](/variant/mdm2-p-ser122leu).

### Data sources & attribution {#sources}

ClinVar (NCBI — public domain, built 2026-10-14); gnomAD v4.1 (Broad Institute, built 2026-10-15); AlphaMissense (Cheng et al. 2023, © Google DeepMind — CC BY 4.0, built 2026-01-27); REVEL (Ioannidis et al. 2016 — ODbL, built 2026-07-13); SaProt (Su et al. 2023 — MIT, built 2026-10-14); SpliceAI (Illumina — free for non-commercial use, built 2026-10-13); CADD (Rentzsch et al. 2019, University of Washington — free for non-commercial use, built 2026-10-10); Conservation (phyloP/phastCons/GERP) (UCSC hg38 470-way mammal (Hiller Lab) + Ensembl Compara, built 2026-07-12); gnomAD Non-coding Constraint (Gnocchi) (Chen et al. 2024, Broad Institute — CC0, built 2026-10-11); gnomAD Regional Missense Constraint (Broad Institute — CC0, built 2026-10-13); Pangolin (Zeng & Li 2022 — CC BY 4.0, built 2026-10-11); Repeat regions (UCSC — RepeatMasker, TRF, segmental duplications, built 2026-10-11); ClinGen (ClinGen, built 2026-09-22); UniProt (CC BY 4.0); Reactome / GO (CC BY 4.0, built 2026-09-23); MaveDB (per-record license, built 2026-10-11); CIViC (CC0, built 2026-09-22); Orphanet (Orphanet, built 2026-06-12)

*Primary record: NCBI ClinVar (variation 1635742). Classifications reflect these databases as of the page's build date and may change. Free reference use — not medical advice; consult the primary submitters and a clinician.*