A paper published in the Internal Medicine Journal and led by former VCCC Alliance Research and Education Lead, Haematology, Professor Constantine Tam, has standardised testing for patients with mantle cell lymphoma (MCL).
The VCCC Alliance enabled the findings through sponsorship of representative working groups to review the role of TP53 mutation testing in the management of newly diagnosed MCL.
For many patients with this diagnosis, MCL is an aggressive form of non-Hodgkin lymphoma that is treated in younger patients with chemoimmunotherapy induction followed by consolidation with autologous stem cell transplantation (ASCT), and in older patients with reduced-intensity regimens.
Analysis of patients enrolled in previous studies Nordic MCL2 and MCL3 showed the clinical impact of TP53 mutation was profound; those who carried acquired deleterious TP53 mutations (11% of the assessable cohort) had a median overall survival of 1.8 years compared to 12.7 years.
The ‘Guardian of the Genome’
The TP53 gene is responsible for creating tumour protein p53, which is essential for regulating DNA repair and cell division. P53 proteins are crucial in vertebrates, where they prevent cancer formation, and for this reason are known as the ‘Guardian of the Genome’.
TP53 status dramatically changes how MCL is treated for an individual patient, and its importance can be underestimated by hospitals. The test is not currently funded, and it is hoped this consensus statement will provide impetus for both hospitals and governments to fund the test.
Professor Tam said he was delighted the findings from the statement could be applied in hospitals immediately.
“It gives me great pleasure to see real practice change in the assessment and management of this uncommon but devastating type of lymphoma implemented at hospitals Victoria-wide,” he said.
“The fact that the VCCC Alliance is able to transcend individual health services and enable meaningful collaboration between hospitals and physicians from all over Victoria speaks to the strength of the alliance in advancing cancer care across the state.”
TP53 testing is now routine at the following major hospitals:
- Alfred Hospital
- Austin Hospital
- Box Hill Hospital
- Monash Health
- Northern Health
- Peninsula Health
- Peter MacCallum Cancer Centre
- Royal Melbourne Hospital
- St Vincent's Hospital
- Western Health