Biomarkers...From the start of Webcafe in '98 I've been following this stuff, waiting for it to be incorporated into practice, more on biomarkers, from WebCafe, John Stein gave me permission to use his quote:
An article from Journal of the National Cancer Institute, July 15, 1998, discusses a multi-centre, randomised clinical trial using p53-status of tumour cells and other molecular markers like p21 to guide treatment decisions in bladder cancer patients, one of the first of it’s kind.
The research team from USC/Norris Comprehensive Cancer Center conducted a study on 242 patients with locally confined bladder tumors who were followed for an average of 8.5 years. Analysis was done of of the p21 protein and it’s interaction with the p53 protein. Results of the study indicated that patients with p21-positive tumours survived disease-free significantly longer than those patients with p21-negative tumours. Furthermore, it was shown that the way the p21 and p53 proteins interact with each other can give a very good indication of which patients must be considered at high risk for recurrence.
The article stated that p53 is known to be a primary regulator of p21, since genetic changes in p53 may lead to loss of p21 expression and function. This in turn leads to unregulated cell growth, and is thought to contribute to the aggressive behaviour of some tumours. "We reasoned that if p21 is [positively] expressed despite alterations in p53, then cell cycle control might be maintained and the tumours would be less likely to progress," said Dr. Richard Cote, M.D., Ass. Prof. of Pathology and Urology, and researcher at Norris. "Our hypothesis seems confirmed by this study.”
Patients with p53- altered/p21-negative tumors demonstrated a higher rate of recurrence and worse survival compared with those with p53-altered/p21-positive tumors. Patients with p53-altered/p21-positive tumors demonstrated a similar rate of recurrence and survival as those with p53-wild type tumors.13
John Stein, M. D., Assistant Professor of Urology, an expert on surgical approaches to bladder cancer and a colleague of Cote’s at USC stated; "Molecular markers will allow us to manage patients with a clearer idea of the benefits of treatment in that individual. This represents a greatadvantage to physicians and patients.”
July 15, 1998 Journal of the National Cancer Institute