MRF-Logo2019-Horizontal-RGB
T-Cell infiltration biopsy
REGISTER
The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

T-Cell infiltration biopsy

› Forums › General Melanoma Community › T-Cell infiltration biopsy

  • Post
    • May 20, 2016 at 12:28 am
    jade1111
    Participant

      Hello! Has anyone has this? And used the results to help determine course of treatment?

      Low T cells indicating need for more aggressive care versus standard? 

      My mom just had done at UCSF, and we are thinking she may vear towards a trial now versus standard care based on what we are guessing results are.

       

      Thanks!!

    Viewing 5 reply threads
    • Replies
        • May 22, 2016 at 1:59 am
        knittingirl
        Participant

          Yes I had also a low T cell infiltration ( I am currently treated at UCSF ) and he advised me to go for a combo ipi/nivo  ( that is more agressive) instead of only nivo. My tumor disppeared quickly after the third infusion ( I could feel it at that time in  my groin).

          Hope it will help,

           

           

            • May 22, 2016 at 7:42 pm
            jade1111
            Participant

              Thanks so much for that input!!! One of my mom's areas is a tumor in the groin as well. They just started a trial that is Optivo plus Epacadostat so my mom is leaning towards that at UCSF. The T cell infiltration biopsy does not seem to be standard have had a hard time finding information on it.

              So glad that the treatment is helping you!

              All the best to you!!

              • May 22, 2016 at 7:42 pm
              jade1111
              Participant

                Thanks so much for that input!!! One of my mom's areas is a tumor in the groin as well. They just started a trial that is Optivo plus Epacadostat so my mom is leaning towards that at UCSF. The T cell infiltration biopsy does not seem to be standard have had a hard time finding information on it.

                So glad that the treatment is helping you!

                All the best to you!!

                • May 22, 2016 at 7:42 pm
                jade1111
                Participant

                  Thanks so much for that input!!! One of my mom's areas is a tumor in the groin as well. They just started a trial that is Optivo plus Epacadostat so my mom is leaning towards that at UCSF. The T cell infiltration biopsy does not seem to be standard have had a hard time finding information on it.

                  So glad that the treatment is helping you!

                  All the best to you!!

                • May 22, 2016 at 1:59 am
                knittingirl
                Participant

                  Yes I had also a low T cell infiltration ( I am currently treated at UCSF ) and he advised me to go for a combo ipi/nivo  ( that is more agressive) instead of only nivo. My tumor disppeared quickly after the third infusion ( I could feel it at that time in  my groin).

                  Hope it will help,

                   

                   

                  • May 22, 2016 at 1:59 am
                  knittingirl
                  Participant

                    Yes I had also a low T cell infiltration ( I am currently treated at UCSF ) and he advised me to go for a combo ipi/nivo  ( that is more agressive) instead of only nivo. My tumor disppeared quickly after the third infusion ( I could feel it at that time in  my groin).

                    Hope it will help,

                     

                     

                    • May 22, 2016 at 11:52 pm
                    chalroad5
                    Participant

                      So sorry that your mom and your family have to go through this. I am stage 4 and am also being treated at UCSF. Not only are they looking at T cell infiltration, but also T cell exhaustion as predictive markers of response to immune checkpoint blockade (the anti-PD-1 and anti-CTLA-4 medications). Prior to the start of my treatment, I had a subcutaneous lesion biopsied that was sent to the UCSF lab for this analysis. Has your mom's doctor discussed these results with her, specifically T cell exhaustion?

                      Higher exhaustion values seem to suggest a greater likelihood of response to PD-1 monotherapy. The caveat is, as far as I'm aware, there isn't yet published literature on the topic and this is far from being an accepted predictive biomarker. That being said, here's an abstract from a poster that the UCSF team will be presenting on T cell exhaustion at the upcoming ASCO conference, which may help guide your decision: http://abstracts.asco.org/176/AbstView_176_170718.html.

                      I would also suggest getting a second opinion from another melanoma specialist (everyone should). Wishing your mom the best during her treatment!

                        • May 23, 2016 at 1:20 am
                        jade1111
                        Participant

                          Thanks so much for that information. My mom was originally at Stanford (its also where she had the WLE and SNB that came back negative). They suggested Keytruda infusions. We went to UCSF for second opinion. The biopsy was done just the other week with the thought of joining trial depending on results. We go in this week for those results. But I dont think they are good as they asked us to come in for appointment to discuss. If they were good based on my moms location we had considered using a local oncologist to admistister and then following up at UCSF with scans. My guess and its a guess is that they want to recommened a more aggressive therapy then the standard. We have not heard them mention T cell exhaustion? 

                          Have you been pleased with your care at UCSF? Any sugegstions for navigating process appreciated.

                          I hope your treatments are going well! And sorry you have to be faced with this..Wishing you all the best!

                          • May 26, 2016 at 12:57 am
                          chalroad5
                          Participant

                            I've been very pleased with the doctors and staff at the UCSF melanoma center, and I've seen other folks post here who have also had positive experiences. For me, the question was, do I trust my doctor to guide me to making some really important and difficult decisions.

                            With respect to the T cell infiltration / exhaustion, all other things being equal, it seems to me that they are more likely to recommend and are recommending monotherapy (Nivo/PD-1) when the numbers are high and a more aggressive approach (Ipi-Nivo) otherwise. But it also seems that they are keen on the Nivo and IDO combination for its effectiveness and its lower side effect profile. And/or the thinking could be that IDO adds a different mechanism of action to attack the tumors and maximizes response for that reason.

                            My T cell exhaustion number was high and Dr. Daud recommended that I take Nivo alone, or Nivo with the IDO medication, although he was not opposed to the Ipi-Nivo combo. I nevertheless opted for the Ipi-Nivo combo because it remains the standard of care and I wanted to maximize my chances to see a quick and robust response.

                            • May 26, 2016 at 12:57 am
                            chalroad5
                            Participant

                              I've been very pleased with the doctors and staff at the UCSF melanoma center, and I've seen other folks post here who have also had positive experiences. For me, the question was, do I trust my doctor to guide me to making some really important and difficult decisions.

                              With respect to the T cell infiltration / exhaustion, all other things being equal, it seems to me that they are more likely to recommend and are recommending monotherapy (Nivo/PD-1) when the numbers are high and a more aggressive approach (Ipi-Nivo) otherwise. But it also seems that they are keen on the Nivo and IDO combination for its effectiveness and its lower side effect profile. And/or the thinking could be that IDO adds a different mechanism of action to attack the tumors and maximizes response for that reason.

                              My T cell exhaustion number was high and Dr. Daud recommended that I take Nivo alone, or Nivo with the IDO medication, although he was not opposed to the Ipi-Nivo combo. I nevertheless opted for the Ipi-Nivo combo because it remains the standard of care and I wanted to maximize my chances to see a quick and robust response.

                              • May 26, 2016 at 12:57 am
                              chalroad5
                              Participant

                                I've been very pleased with the doctors and staff at the UCSF melanoma center, and I've seen other folks post here who have also had positive experiences. For me, the question was, do I trust my doctor to guide me to making some really important and difficult decisions.

                                With respect to the T cell infiltration / exhaustion, all other things being equal, it seems to me that they are more likely to recommend and are recommending monotherapy (Nivo/PD-1) when the numbers are high and a more aggressive approach (Ipi-Nivo) otherwise. But it also seems that they are keen on the Nivo and IDO combination for its effectiveness and its lower side effect profile. And/or the thinking could be that IDO adds a different mechanism of action to attack the tumors and maximizes response for that reason.

                                My T cell exhaustion number was high and Dr. Daud recommended that I take Nivo alone, or Nivo with the IDO medication, although he was not opposed to the Ipi-Nivo combo. I nevertheless opted for the Ipi-Nivo combo because it remains the standard of care and I wanted to maximize my chances to see a quick and robust response.

                                • May 23, 2016 at 1:20 am
                                jade1111
                                Participant

                                  Thanks so much for that information. My mom was originally at Stanford (its also where she had the WLE and SNB that came back negative). They suggested Keytruda infusions. We went to UCSF for second opinion. The biopsy was done just the other week with the thought of joining trial depending on results. We go in this week for those results. But I dont think they are good as they asked us to come in for appointment to discuss. If they were good based on my moms location we had considered using a local oncologist to admistister and then following up at UCSF with scans. My guess and its a guess is that they want to recommened a more aggressive therapy then the standard. We have not heard them mention T cell exhaustion? 

                                  Have you been pleased with your care at UCSF? Any sugegstions for navigating process appreciated.

                                  I hope your treatments are going well! And sorry you have to be faced with this..Wishing you all the best!

                                  • May 23, 2016 at 1:20 am
                                  jade1111
                                  Participant

                                    Thanks so much for that information. My mom was originally at Stanford (its also where she had the WLE and SNB that came back negative). They suggested Keytruda infusions. We went to UCSF for second opinion. The biopsy was done just the other week with the thought of joining trial depending on results. We go in this week for those results. But I dont think they are good as they asked us to come in for appointment to discuss. If they were good based on my moms location we had considered using a local oncologist to admistister and then following up at UCSF with scans. My guess and its a guess is that they want to recommened a more aggressive therapy then the standard. We have not heard them mention T cell exhaustion? 

                                    Have you been pleased with your care at UCSF? Any sugegstions for navigating process appreciated.

                                    I hope your treatments are going well! And sorry you have to be faced with this..Wishing you all the best!

                                  • May 22, 2016 at 11:52 pm
                                  chalroad5
                                  Participant

                                    So sorry that your mom and your family have to go through this. I am stage 4 and am also being treated at UCSF. Not only are they looking at T cell infiltration, but also T cell exhaustion as predictive markers of response to immune checkpoint blockade (the anti-PD-1 and anti-CTLA-4 medications). Prior to the start of my treatment, I had a subcutaneous lesion biopsied that was sent to the UCSF lab for this analysis. Has your mom's doctor discussed these results with her, specifically T cell exhaustion?

                                    Higher exhaustion values seem to suggest a greater likelihood of response to PD-1 monotherapy. The caveat is, as far as I'm aware, there isn't yet published literature on the topic and this is far from being an accepted predictive biomarker. That being said, here's an abstract from a poster that the UCSF team will be presenting on T cell exhaustion at the upcoming ASCO conference, which may help guide your decision: http://abstracts.asco.org/176/AbstView_176_170718.html.

                                    I would also suggest getting a second opinion from another melanoma specialist (everyone should). Wishing your mom the best during her treatment!

                                    • May 22, 2016 at 11:52 pm
                                    chalroad5
                                    Participant

                                      So sorry that your mom and your family have to go through this. I am stage 4 and am also being treated at UCSF. Not only are they looking at T cell infiltration, but also T cell exhaustion as predictive markers of response to immune checkpoint blockade (the anti-PD-1 and anti-CTLA-4 medications). Prior to the start of my treatment, I had a subcutaneous lesion biopsied that was sent to the UCSF lab for this analysis. Has your mom's doctor discussed these results with her, specifically T cell exhaustion?

                                      Higher exhaustion values seem to suggest a greater likelihood of response to PD-1 monotherapy. The caveat is, as far as I'm aware, there isn't yet published literature on the topic and this is far from being an accepted predictive biomarker. That being said, here's an abstract from a poster that the UCSF team will be presenting on T cell exhaustion at the upcoming ASCO conference, which may help guide your decision: http://abstracts.asco.org/176/AbstView_176_170718.html.

                                      I would also suggest getting a second opinion from another melanoma specialist (everyone should). Wishing your mom the best during her treatment!

                                  Viewing 5 reply threads
                                  • You must be logged in to reply to this topic.
                                  About the MRF Patient Forum

                                  The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                                  The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                                  Popular Topics