Published on March 20, 2019
How sophisticated should testing be before starting treatment for chronic lymphocytic leukemia (CLL)? As part of our coverage of the 2018 American Society of Hematology (ASH) annual meeting, noted CLL expert Javier Pinilla-Ibarz, from the H. Lee Moffitt Cancer Center & Research Institute, joined Patient Power to discuss what kind of testing is done for CLL, when it is recommended and how the results are used. Watch now to find out more.
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Transcript | Tests to Get Before Receiving CLL Personalized Medicine
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So, we talk about personalized medicine. And in a way, that’s what we’re talking about here. And now, there can be these genomic panels looking at all of these different genes, not just TP53, but some we don’t even understand, right. You can get all of this big result back, and you know what some of it means, and some we don’t know yet. How sophisticated should the testing be, Dr. Pinilla, and when, to try make a recommendation for a patient, where they need initial treatment or another line of treatment?
So, I think it is an important question.
And Moffitt is really into this where you are.
It’s an important question that the last iwCLL kind of revised criteria has been published last summer. And it’s tried to address some of these issues. When, how, what kind of test, what type of test? I think, what we know for sure is that this test and IgVH mutation analysis is something that should be done.
The question is should it be done at diagnosis or should it be done at diagnosis before therapy? For sure, before therapy to, as we discussed, try to stratify the patient and give the right therapy. Obviously, patients come to our clinic, and they are asking a lot of questions that we cannot really answer without having some kind of what I call a crystal ball. I try to really look at the crystal ball with all of these markers, and I try to see, well, the possibility the patient is going to require therapy sooner or rather than later, right. And all of these genomic tests may really add some of this information.
However, it’s not prime time for that. We do really recommend on the iwCLL TP53 mutation, because it’s an important one. The rest of them, they may have a prognostic value. But for now, we are not really having any targeted therapy. And it’s questionable, if they have to be done in everything or more in the research.
The patient wants to know. And sometimes, the patient is asking for these things. The question is how are we going to really make the interpretation on how we’re going to translate this very complicated information to our patient is a different story.