Two participants with leiomyosarcoma carried pathogenic variants and same-gene second hits in RB1 and TP53, which have known connections to this condition [48,49,50], and one carried a pathogenic variant without a detectable in-gene second hit in the DDX41 gene, without any known connection to leiomyosarcoma. This evidence concerns the gene TP53 and leiomyosarcoma.