Background:

-A gene provides instructions to the body. Mutated genes can sometimes cause cancer. Germline mutations are those people are born with. These mutations in the BAP1 gene can cause mesothelioma and other cancers. Researchers want to study people with germline mutations of BAP1 and other genes known to cause cancer.

Objective:

-To learn how cancer might develop in people with BAP1 mutations.

Eligibility:

-People ages 2 and older with a germline mutation in BAP1

Design:

• Participants will be screened with:

  • Medical and family history
  • Saliva test

• Participants with mesothelioma will be in the NIH Group. Participants without mesothelioma can choose to be in either the NIH Group or the Remote Group.

• Remote Group participants will have a medical and family history by phone. If they have tumor tissue from a previous surgery, it will be tested. They will be contacted once a year by phone.

• NIH Group participants will have a baseline visit. This can take up to 4 days. They may have to stay in the area overnight. The visit will include:

  • Physical exam
  • Evaluation of tumor tissue if available
  • Optional tumor biopsy
  • Blood tests
  • Scans: A machine will take pictures of the body.
  • Photographs of skin lesions or other issues
  • Skin exam
  • Eye exam

• NIH Group participants will have visits once or twice a year. These will include a physical exam, lab tests, scans, and other tests as needed.

• Participants who have a confirmed mutation will be asked to contact any relatives who may be at risk and ask them about joining the study.

Background:

• BRCA1-Associated Protein-1 (BAP1), a deubiquitinase involved in regulating DNA repair enzymes, is believed to be a prominent mutation in malignant mesothelioma.
• Germline mutations involving BAP1 have been reported in familial studies. These have been associated with a higher likelihood of mesothelioma as well as several other malignancies, including uveal melanoma, cutaneous melanomas, renal cell carcinoma and cholangiocarcinoma.
• BAP1 mutations, if found, have a high probability of detecting multiple malignancies in family members.

Objectives:

-To characterize the natural and clinical history of patients with malignant mesothelioma, their family members and individuals who have germline mutations in BAP1

Eligibility for Genetic Testing:

Cohort 1

-Individual with mesothelioma with deleterious germline mutations in BAP1 (previous testing may have been research or clinical)

OR

• Individual with a diagnosis of mesothelioma who is otherwise eligible for testing on Cohort 2
• Age >= 2

Cohort 2

-Individual with a germline BAP1 mutation who does not have a history of mesothelioma (previous testing may have been research or clinical)

OR

-Individual with no personal history of mesothelioma with:

--a first degree biological relative (living or deceased) with a history of mesothelioma

OR

--a first degree biological relative with a CLIA (or equivalent) confirmed germline mutation in BAP1

OR

--a second degree biological relative with a CLIA (or equivalent) confirmed germline mutation in BAP1 if relevant first degree relative is deceased or unavailable for testing

OR

--a second degree biological relative with mesothelioma and a CLIA (or equivalent) confirmed germline mutation in BAP1

-Age >= 2

Eligibility for Surveillance:

Cohort 1

-No additional criteria

Cohort 2

-Testing performed on study must confirm presence of germline mutation in BAP1

Design:

• Individuals with suspected hereditary predisposition to mesothelioma and their families will be recruited to assess for genetic mutations, and to study the natural history of malignancies occurring in germline BAP1 mutations.
• Screening examinations will be offered to those with germline BAP1 mutations.
• We will determine if there is a relationship between germline mutation and disease phenotype.

• Inclusion Criteria for Genetic Testing:

Cohort 1:

• Participant with pathology confirming a diagnosis of mesothelioma.
• Participant must have a deleterious germline BAP1 mutation. Results from either research or clinical analyses are sufficient for this criterion.

OR

• Participant with mesothelioma otherwise eligible for genetic testing in Cohort 2
• Age >= 2 years

Cohort 2:

-Individual with a germline BAP1 mutation who does not have a history of mesothelioma (other cancers are allowed). Results from either research or clinical analyses are sufficient for this criterion.

OR

-Individual with no history of mesothelioma with:

--A biological first degree relative (living or deceased) with a history of mesothelioma

OR

--A first degree biological relative with a CLIA (or equivalent) confirmed germline mutation in BAP1

OR

--A second degree biological relative with a CLIA (or equivalent) confirmed germline mutation in BAP1 if relevant first degree relative is deceased or unavailable for testing,

OR

--A second degree biological relative with mesothelioma and a CLIA (or equivalent) confirmed germline mutation in BAP1

-Age >= 2 years

All participants must understand and be willing to sign a written informed consent

Exclusion Criteria for Genetic Testing

None

Inclusion Criteria for Surveillance:

Inclusion Criteria for Surveillance

• Genetic testing criteria including age restrictions for respective cohorts must be met.

• Participants in Cohort 1 may be enrolled with positive results for germline BAP1 mutation regardless of CLIA (or equivalent) confirmation

• Participants in Cohort 2:

  • must have CLIA (or equivalent) confirmed germline BAP1 mutation

Exclusion Criteria for Surveillance

None

Persons with mesothelioma and family members as well as individuals with CLIA documented germline BAP-1.

All IPD recorded in the medical record will be shared with intramural investigators upon request. In addition all large scale genomic sequencing data will be shared with subscribers to dbGaP.

Clinical data in BTRIS will be shared throughout the course of the study and indefinitely with the permission of the investigator.@@@@@@Genomic data will be shared from the time of upload to dbGaP.

Clinical IPD will be shared through the BTRIS database for open ended analysis. All BTRIS subscribers, generally limited to the NIH Clinical Center, may request data.@@@@@@Genomic IPD will be shared through dbGaP, per rules of the database, for purposes of genomic analysis.