ATM and lung carcinoma: Yet, this does not appear to be a reliable finding as the frequency of biallelic two-hit events across all cancers where a germline pathogenic variant is present has been estimated at 38.3%, with a recent study finding that ATM somatic second hits occurred in 11.3% in a wide spectrum of cancers including breast, pancreatic, bladder, uterine and lung cancers, among others (15, 47).