Jonathan M. Gerber, MD, is a member of the faculty in the Department of Medicine at New York University (NYU) Grossman School of Medicine; as well as the chief clinical officer of the NYU Perlmutter Cancer Center. 

Dr Gerber on the Benefits of p53 IHC Testing for Identifying TP53-Mutant MDS and AML in Underserved Regions

"Within the United States, in some of our more underserved and rural areas where there might not be ready access both to the expertise with NGS and NGS testing [itself], this is a relatively simple, straightforward assay. Hopefully, this [tool] can expedite early referral and facilitate early referral to transplant-capable centers."

Jonathan M. Gerber, MD, a member of the faculty in the Department of Medicine at New York University (NYU) Grossman School of Medicine; as well as the chief clinical officer of the NYU Perlmutter Cancer Center, discussed the potential for implementing p53 immunohistochemistry (IHC) testing as a cost-effective alternative to next-generation sequencing (NGS) in regions with limited molecular diagnostic resources.

Findings from a recent analysis led by Gerber and colleagues suggest that IHC-based stratification may serve as a viable method for identifying high-risk patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) who harbor multi-hit 

In the study, a p53 IHC positivity threshold of 7% was found to best correlate with multi-hit 

 mutational status in a cohort of 82 patients with concurrent IHC and NGS data. Higher IHC positivity was also associated with worse overall survival, reinforcing the prognostic relevance of this metric. Notably, false-negative IHC results were observed exclusively in cases involving sole nonsense or frameshift 

 mutations, suggesting limitations in IHC sensitivity for detecting certain mutational subtypes.

Gerber emphasized the practical value of p53 IHC in underserved or rural settings, where access to comprehensive NGS testing and hematopathology expertise may be limited. As a widely available and relatively simple assay, IHC could help expedite early risk stratification and referral to transplant-capable centers. He also noted the potential for artificial intelligence to support automated interpretation and standardization of IHC results, which could further increase its scalability and reliability in community settings.

Importantly, IHC provides functional insights into p53 protein behavior—such as abnormal localization or intensity of staining—that may not be directly inferred from DNA-level sequencing alone, Gerber noted. This added layer of information could help clinicians identify candidates for clinical trials investigating therapies for 

-mutated disease, particularly given the poor prognosis and limited treatment options associated with high-burden 

alterations. Early molecular characterization using accessible tools such as p53 IHC could therefore facilitate timely trial enrollment and improve care pathways in MDS and AML, Gerber concluded.

Videos

Jonathan M. Gerber, MD, discusses the potential implementation of p53 IHC testing for MDS and AML in regions with limited access to NGS.

Shyam A. Patel, MD, PhD, is an associate professor at the University of Massachusetts Chan Medical School; as well as a hematologist and oncologist at the UMass Memorial Medical Center.

, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s OncClub episode, we had the pleasure of speaking with Jonathan M. Gerber, MD; and Shyam A. Patel, MD, PhD, about a study they conducted investigating the use of immunohistochemistry (IHC) as a biomarker for early 

 mutation identification in patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Dr Gerber is a member of the faculty in the Department of Medicine at New York University (NYU) Grossman School of Medicine; as well as the chief clinical officer of the NYU Perlmutter Cancer Center. Dr Patel is an associate professor at the University of Massachusetts Chan Medical School; as well as a hematologist and oncologist at the UMass Memorial Medical Center in Worcester. 

In our exclusive interview, Drs Gerber and Patel discussed the evaluation of p53 IHC as a surrogate biomarker for 

-mutant MDS and AML. They shared how the presence of 

 mutations in these diseases significantly worsens prognosis, necessitating urgent treatment. They also highlighted how IHC results are available within 48 to 72 hours. Gerber and Patel explained this study's design and patient population, as well as how IHC's inverse correlation with overall survival highlights its potential as an early biomarker, though it has lower sensitivity for certain mutations.

 to see additional findings and insights from this research! 
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Podcasts

Drs Gerber and Patel discuss a study they conducted investigating the use of IHC as a biomarker for early TP53 mutation identification in MDS and AML.

Jonathan M. Gerber, MD

Articles

Dr Gerber on the Benefits of p53 IHC Testing for Identifying TP53-Mutant MDS and AML in Underserved Regions

IHC Testing Leads to Early Detection of TP53-Mutant AML and MDS: With Jonathan M. Gerber, MD; and Shyam A. Patel, MD, PhD