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This quarter’s Tribune will review some simple facts related to the most dreaded predictive factors, namely 17p deletion and p53.
- All studies by necessity, look at data backward, so relying on old CLL mortality statistics is a mistake in the modern era of better care and targeted therapies.
- With all the new therapies now available, biomarkers such as 17p deletion are now increasingly being viewed as “predictive factors” suggesting what therapies will work well and which won’t, rather than “prognostics factors” suggesting a shorter life span.
- It is no longer adequate to test only for 17p deletion. It is important to test for p53 that is found to be nonfunctional in a small but significant number of patients without 17p deletion.
- The TP53gene lives on the short arm of the 17th chromosome (17p). It provides instructions for making the protein p53. p53 is a tumor suppressor that keeps cells from dividing too fast or in an uncontrolled way. Its absence or dysfunction predicts for a poor response to traditional chemotherapy, but much less so for the newer targeted therapies.
Dr. Brian Koffman, a well-known doctor, educator and clinical professor turned patient has dedicated himself to teaching and helping the CLL community since his diagnosis in 2005. He serves as the medical director of the CLL Society Inc.
Originally published in The CLL Tribune Q3 2018.