TSC2 I365del
Gene Variant Detail

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Gene TSC2
Variant I365del
Impact List deletion
Protein Effect loss of function
Gene Variant Descriptions TSC2 I365del results in the deletion of an amino acid in the Tsc2 protein at amino acid 365 (UniProt.org). I365del confers a loss of function on Tsc2, as demonstrated by abolished tuberin-hamartin binding in a yeast assay (PMID: 11741833), and failure to inhibit Mcp-1 production in cell culture (PMID: 16129702).
Associated Drug Resistance
Category Variants Paths

TSC2 mutant TSC2 inact mut TSC2 I365del

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Transcript NM_000548.5
gDNA chr16:g.2060787_2060789delATC
cDNA c.1093_1095delATC
Protein p.I365delI
Source Database RefSeq
Genome Build GRCh38/hg38
Transcript gDNA cDNA Protein Source Database Genome Build
NM_001114382 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001370405.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001318829 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001318827.2 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38
XM_011522640 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_000548.4 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001077183 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406698.1 chr16:g.2076123_2076125delAGG c.1093_1095delAGG p.R365delR RefSeq GRCh38/hg38
NM_001114382.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001318829.1 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001406684.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
XM_011522639 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_005255531 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522638.2 chr16:g.2058829_2058831delTCT c.1093_1095delTCT p.S365delS RefSeq GRCh38/hg38
NM_001406673.1 chr16:g.2060800_2060802delTTC c.1094_1096delTTC p.L365delL RefSeq GRCh38/hg38
XM_017023617.1 chr16:g.2058829_2058831delTCT c.1093_1095delTCT p.S365delS RefSeq GRCh38/hg38
NM_001114382.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406695.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
XM_011522640.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406696.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001406683.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001318829.2 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001318831 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
XM_005255529.4 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522637.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406679.1 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001406667.1 chr16:g.2060698_2060700delCCT c.1094_1096delCCT p.S365delS RefSeq GRCh38/hg38
XM_011522636.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_000548 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001318831.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001406692.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001406663.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522637 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406671.1 chr16:g.2060800_2060802delTTC c.1094_1096delTTC p.L365delL RefSeq GRCh38/hg38
NM_001406664.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_021055.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406689.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001370404.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_017023618.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001406682.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001406691.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001406693.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001318827 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38
XM_017023615.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406694.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
XM_011522636 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406678.1 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38
NM_001406688.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
XM_011522639.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406675.1 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001406686.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
XM_017023616 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_005255531.4 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001318832.1 chr16:g.2060754_2060756delCAG c.1093_1095delCAG p.Q365delQ RefSeq GRCh38/hg38
NM_001406680.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001406685.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001318832 chr16:g.2060754_2060756delCAG c.1093_1095delCAG p.Q365delQ RefSeq GRCh38/hg38
NM_001318832.2 chr16:g.2060754_2060756delCAG c.1093_1095delCAG p.Q365delQ RefSeq GRCh38/hg38
NM_000548.5 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522638.3 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38
NM_001406676.1 chr16:g.2061991_2061993delTGT c.1093_1095delTGT p.C365delC RefSeq GRCh38/hg38
NM_001406681.1 chr16:g.2064383_2064385delTGC c.1093_1095delTGC p.C365delC RefSeq GRCh38/hg38
NM_001077183.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522638 chr16:g.2058829_2058831delTCT c.1093_1095delTCT p.S365delS RefSeq GRCh38/hg38
NM_001318831.2 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
XM_017023616.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406690.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
XM_011522636.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001363528.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_011522637.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_005255529 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406697.1 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
NM_001406665.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_017023617 chr16:g.2058829_2058831delTCT c.1093_1095delTCT p.S365delS RefSeq GRCh38/hg38
XM_024450413.1 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001406687.1 chr16:g.2065612_2065614delCTG c.1093_1095delCTG p.L365delL RefSeq GRCh38/hg38
NM_001406670.1 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38
NM_001406668.1 chr16:g.2060698_2060700delCCT c.1094_1096delCCT p.S365delS RefSeq GRCh38/hg38
NM_001406677.1 chr16:g.2061901_2061903delGTC c.1093_1095delGTC p.V365delV RefSeq GRCh38/hg38
XM_017023618 chr16:g.2074282_2074284delTGG c.1094_1096delTGG p.V365delV RefSeq GRCh38/hg38
XM_011522639.3 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001077183.2 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
XM_017023615 chr16:g.2060787_2060789delATC c.1093_1095delATC p.I365delI RefSeq GRCh38/hg38
NM_001318827.1 chr16:g.2061955_2061957delGGG c.1093_1095delGGG p.G365delG RefSeq GRCh38/hg38

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Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
TSC2 inact mut Advanced Solid Tumor no benefit Everolimus Phase II Actionable In a Phase II trial, Afinitor (everolimus) treatment resulted in limited activity with an objective response rate of 7% (2/30, 2 partial responses), stable disease in an additional 40% (12/30), a clinical benefit rate of 13% (4/30), a median progression-free survival of 2.3 months, and a median overall survival of 7.3 months in patients with advanced solid tumors harboring inactivating TSC1 or TSC2 mutations or activating MTOR mutations (PMID: 33727259; NCT02201212). 33727259
TSC2 inact mut renal cell carcinoma predicted - sensitive Temsirolimus Clinical Study - Cohort Actionable In a retrospective analysis, 28% (12/43) of metastatic renal cell carcinoma patients who responded to rapalogs, Afinitor (everolimus) or Torisel (temsirolimus), harbored inactivating TSC1, TSC2 mutations and/or activating MTOR mutations, compared to 11% (4/36) in patients who did not respond to therapy (PMID: 26831717). 26831717
TSC2 inact mut clear cell renal cell carcinoma not applicable N/A Guideline Risk Factor Germline inactivating mutations in TSC2 result in tuberous sclerosis complex (TSC), which is associated with increased risk of developing clear cell renal cell carcinoma (NCCN.org). detail...
TSC2 inact mut transitional cell carcinoma no benefit Sapanisertib Phase II Actionable In a Phase II trial, treatment with Sapanisertib (MLN0128) in metastatic urothelial carcinoma patients with either a TSC1 or TSC2 activating mutation (n=13) did not result in an objective response and led to a median overall survival of 3.4 months, and the trial was terminated early due to limited clinical activity and poor drug tolerability (Journal of Clinical Oncology 39, no. 6_suppl (February 20, 2021) 431-431; NCT03047213). detail...
TSC2 inact mut perivascular epithelioid cell tumor predicted - sensitive Nab-rapamycin Phase II Actionable In a Phase II trial (AMPECT), Fyarro (nab-rapamycin) treatment in patients with perivascular epithelioid cell tumors (PEComas) resulted in partial response in 20% (1/5) of patients with TSC1 mutations, 89% (8/9) of patients with TSC2 mutations, and 9% (1/11) of patients without a TSC1 or TSC2 mutation (PMID: 34637337; NCT02494570). 34637337
TSC2 inact mut Advanced Solid Tumor no benefit LY3023414 Case Reports/Case Series Actionable In a Phase II trial (NCI-COG Pediatric MATCH), Samotolisib (LY3023414) treatment resulted in no objective responses in pediatric patients with advanced solid tumors harboring PI3K/mTOR pathway mutations, including PTEN (n=6), PIK3CA (n=5), TSC1 (n=2), TSC2 (n=3), and PIK3R1 (n=1), and resulted in a 3-month progression-free survival of 12%, a 6-month overall survival of 44%, and a 12-month overall survival of 15% (PMID: 39298693; NCT03155620). 39298693
TSC2 inact mut Advanced Solid Tumor predicted - sensitive Nab-rapamycin Clinical Study Actionable In a clinical study, Fyarro (nab-rapamycin) treatment in patients with advanced solid tumors harboring mutations in TSC1 or TSC2 led to a partial response in 4 patients, stable disease in 2 patients and progressive disease in 1 patient of 7 enrolled patients (J Clin Oncol 39, no. 15_suppl (May 20, 2021) 3111-3111; NCT03817515). detail...
TSC2 inact mut renal cell carcinoma predicted - sensitive Everolimus Clinical Study - Cohort Actionable In a retrospective analysis, 28% (12/43) of metastatic renal cell carcinoma patients who responded to rapalogs, Afinitor (everolimus) or Torisel (temsirolimus), harbored inactivating TSC1, TSC2 mutations and/or activating MTOR mutations, compared to 11% (4/36) in patients who did not respond to therapy (PMID: 26831717). 26831717
TSC2 inact mut islet cell tumor not applicable N/A Guideline Risk Factor Germline inactivating mutations in TSC2 result in tuberous sclerosis complex (TSC), which is associated with increased risk of developing pancreatic neuroendocrine tumors (NCCN.org). detail...
TSC2 inact mut castration-resistant prostate carcinoma predicted - sensitive CC-115 + Enzalutamide Phase I Actionable In a Phase Ib trial, Xtandi (enzalutamide) plus CC-115 was safe and led to a PSA reduction >= 50% (PSA50) in 80% (32/40) and >=90% (PSA90) in 58% (23/40) of metastatic castration-resistant prostate cancer patients at 12 weeks, and patients with PIK3CA activating mutations or PTEN or TSC1/2 loss of function (n=16) achieved a PSA50, PSA90, and median radiographic progression-free survival of 94%, 63%, and 19.6 mo vs 67%, 47%, and 22.1 mo in PI3K pathway wild-type patients (n=15) (PMID: 37980367; NCT02833883). 37980367
TSC2 mutant subependymal giant cell astrocytoma predicted - sensitive Everolimus Phase III Actionable In a Phase III trial (EXIST-1), Afinitor (everolimus) treatment resulted in a 50% or more tumor reduction in 35% (27/78) of adult and pediatric patients diagnosed with tuberous sclerosis complex and had subependymal giant cell astrocytoma, compared to 0% (0/39) in the placebo group, 85% (99/117) of the patients harbored mutations in TSC1 and/or TSC2 (PMID: 23158522; NCT00789828). 23158522
TSC2 mutant hepatocellular carcinoma decreased response Sorafenib Clinical Study - Cohort Actionable In a clinical case study, Nexavar (sorafenib) treatment of patients with hepatocellular carcinoma harboring Mtor pathway mutations in PIK3CA, PTEN, TSC2, or TSC1 (n=12), resulted in a lower disease control rate (8.3% vs. 40.2%), shorter progression-free survival (1.9 months vs. 5.3 months) and shorter overall survival (10.4 months vs. 17.9 months) compared to patients without mutations in this pathway (n=67) (PMID: 30373752; NCT01775072). 30373752
TSC2 mutant osteosarcoma no benefit Temsirolimus Preclinical - Pdx Actionable In a preclinical study, Torisel (temsirolimus) treatment did not improve event-free survival in an osteosarcoma patient-derived xenograft (PDX) model harboring a TSC2 mutation (PMID: 37523146). 37523146
TSC2 mutant renal cell carcinoma predicted - sensitive Temsirolimus Case Reports/Case Series Actionable In a clinical study, treatment with Afinitor (everolimus) or Torisel (temsirolimus) resulted in more partial responses (odds ratio = 0.08, p=0.030) in patients with renal cell carcinoma harboring mTOR pathway mutations, including MTOR (n=8), TSC1 (n=1), and TSC2 (n=2), than those without mutations (n=76) (PMID: 31335987). 31335987
TSC2 mutant renal cell carcinoma conflicting Everolimus Clinical Study - Cohort Actionable In a retrospective analysis, TSC1, TSC2, or MTOR mutation status was not associated with progression-free survival in renal cell carcinoma patients treated with Afinitor (everolimus) (PMID: 30327302). 30327302
TSC2 mutant renal cell carcinoma conflicting Everolimus Case Reports/Case Series Actionable In a clinical study, treatment with Afinitor (everolimus) or Torisel (temsirolimus) resulted in more partial responses (odds ratio = 0.08, p=0.030) in patients with renal cell carcinoma harboring mTOR pathway mutations, including MTOR (n=8), TSC1 (n=1), and TSC2 (n=2), than those without mutations (n=76) (PMID: 31335987). 31335987
TSC2 mutant lung non-small cell carcinoma no benefit Vistusertib Case Reports/Case Series Actionable In a Phase II trial (NLMT), Vistusertib (AZD2014) treatment did not result in a confirmed response (0/5) or durable clinical benefit (0/5) in patients with non-small cell lung cancer harboring TSC1 or TSC2 mutations, thus the cohort was closed due to futility (PMID: 32669708, NCT02664935). 32669708
TSC2 mutant osteosarcoma no benefit Irinotecan + Temozolomide + Temsirolimus Case Reports/Case Series Actionable In a clinical case study, Torisel (temsirolimus), Temodar (temozolomide), and Camptosar (irinotecan) combination treatment resulted in progressive disease in a pediatric patient with osteosarcoma harboring a TSC2 mutation (PMID: 37523146; NCT03336931). 37523146