Max, thanks for all your contributions to Biotechs. I've read all of the IDEC discussion. Thanks too to Bennett! And Brad and others of course. Meanwhile, today Rituxan is approved. Nice timing. I might buy some. Not the shares, the product. Gee they sell it cheap. Only $10 000 or $12 000 or so I saw it is going to be.|
My brain is full of monoclonal antibodies, CHOP, statistics, B-cells, large diffuse cells, marrow, CAT scans, MRI, leucocytes, lymphocytes, P53 and p53. All that stuff.
Cutting to the chase. I found one item of particular interest. In "Blood", 15 November edition, available on the Web, they reported a study on P53 mutation and p53 expression. If you have mutations of exons 5 through 8, then expression of p53 is a super bad prognosticator. Good if negative. It seems that the failed treatments aren't just bad luck but involve particular histologies which don't get destroyed by the chemotherapies.
The classification systems seem to be archaic taxonomy descriptors rather than genetic based unambiguous facts. I guess with gene chip arrays, laser flow cell identification and the like, diagnostic precision will increase dramatically. The current method of staining and peering through a pair of binoculars seems hopeless.
The p53 seems an especially important prognosticator for NHL. Rituxan should be used as a first line treatment in conjunction with chemotherapy in p53 expressors. [These are my ideas, so I'm looking for comment from people who actually know something about all this stuff. Don't forget, I'm a civil engineer, switched to the oil industry then read a lot about telecommunications and was never interested much in biology. Until now].
I gave a copy of the report to the doctors - all news to them and they are having a think about it. The ideal seems to be minimal chemotherapy, with Rituxan, followed by Y90 labelled monoclonal antibodies avoiding mouse immunity with primatized or humanized molecules.
For those curious. Tarken is Stage 1A, diffuse, intermediate and large cell, cleaved, B-cell. No antigen testing done. No P53 analysis done. I'm pushing. Anyone know were p53 expression can be tested? Poisoning with CHOP starts next week.
Thanks again Max, for all the information you've provided in the threads.