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Hi Tim, if you look at the information reported from checkmate 067, the phase 3 trial of ipi+ nivo and go into tables and graphs you will find some information. The bottom line on winners and loser when it comes to response is still the holly grail of trying to find biomarkers in melanoma. Tumor burden or total volume,LDH, location of tumors and Braf status all have some information, but I have never heard any of the experts in the field state that they know for sure who will respond to the combination. If your tumors have been removed then samples of tumor can be screened for presence of infiltration of TIL CD8 t-cells. The presence of TIL’s is associated with better responses, oncologist’s refer to tumors as being hot or cold based on TIL’s being present. here is a link to article on 5 year survival data from checkmate 067. https://www.nejm.org/doi/full/10.1056/nejmoa1910836
Thanks Ed- I was aware that lack of accurate predictive bio markers is the Achilles heel of melanoma oncology (Dr Jason Luke is big on this, I believe).
Much as I appreciate the treatment I’ve received here in England, I’m not sure my team did a great job on the histo-pathology side. After my first op (axilla excision – I am MUP) the pathology analysis was focused on BRAF testing and staging info. Similarly, after I progressed 8 months after adjuvant pembro, there was no detailed analysis of the TME. Ditto Op. 3 in early August 2021.
I think it was Celeste who mentioned that low tumour burden was a useful indicator of efficacy and I wondered whether that was plain common sense or has been reported in a clinical setting?
Not sure if you have scene the following video links before, what I find of use is the research is trying to find drug or drug combination to overcome resistance (primary or acquired) looking at pathology reports of tumor tissue is important but is only being performed in the research setting and not as standard of care. Celeste gave you a ton of information and I don’t have anything specific on tumor burden (study results) I have read many times over the years that tumor volume and location is a negative indicator. Good luck!!!Ed https://www.youtube.com/watch?v=xIft8dxrfjw https://www.youtube.com/watch?v=_wAUkQdTt1g&list=PLOnM_erAQqIBj54P2wviZ3WxV_okkn58Y
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