Cutaneous metastases are relatively rare and often require an invasive biopsy for diagnosis. A novel, non-invasive RCM-OCT device combines the advantage of reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) by providing RCM high-resolution images in the horizontal plane and OCT low-resolution images in the transverse plane. We describe RCM and OCT characteristics of cutaneous metastases using this device to elucidate its utility for diagnosis and management. Seven patients with clinically suspicious cutaneous metastases from breast cancer were imaged using the RCM-OCT device. We found that the RCM-OCT device can detect cutaneous metastases and aid in non-invasive diagnosis.
There is an urgent need for predictive platforms for response to immunotherapy in patients. In vivo phenotyping of tumor-immune microenvironment (TiME) for predicting response to immunotherapy was evaluated using non-invasive reflectance confocal microscopy (RCM) in skin cancer patients. Phenotypes were correlated with underlying biology and response to topical immunotherapy. Using both inflammation and vasculature features, four major phenotypes were observed. The VaschiInfhi phenotype correlated with high immune activation, exhaustion, and vascular signatures while VaschiInflo with endothelial anergy and immune exclusion. Highest response to immunotherapy was seen in VascloInfhi phenotype. This study establishes proof-of-concept for in vivo TiME phenotyping in patients.
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