Moreover, both presenters concluded that although the prognostic vs predictive value of IGHV and TP53 mutational status remains uncertain, all patients with CLL in clinical practice or enrolled on clinical trials should undergo fluorescence in situ hybridization (FISH) testing, TP53 mutational analysis, and IGHV mutational analysis. Therefore, some debate exists regarding the current utility of these markers in patients receiving continuous therapy with BTK inhibitors or time-limited therapy with venetoclax (Venclexta).ĭuring the debate, Inhye Ahn, MD, of Dana-Farber Cancer Institute, spoke in favor of using old prognostic markers in CLL, whereas Steven Coutre, MD, a professor of medicine at Stanford University, argued against using old prognostic markers.įollowing both presentations, 89% of audience members voted in favor of using old prognostic markers in CLL management, according to a virtual poll. 1,2Īlthough several markers of CLL activity and growth, notably IGHV and TP53 mutational status, are predictive of outcomes with fludarabine, cyclophosphamide, and rituximab (Rituxan FCR), the advent of targeted therapy has largely replaced chemoimmunotherapy as a treatment option for patients with CLL. Historical prognostic markers for chemoimmunotherapy have largely lost their clinically relevance in the context of targeted therapies for patients with chronic lymphocytic leukemia (CLL) however, IGHV and TP53 mutational status remain important predictive markers of response, now for novel treatments, according to a debate that took place during the 2021 SOHO Annual Meeting.

Prognostic vs predictive