Research Papers:
Indoleamine 2,3-dioxygenase 1 and overall survival of patients diagnosed with esophageal cancer
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Abstract
Ari J. Rosenberg4,9, Derek A. Wainwright1,2, Alfred Rademaker1,3, Carlos Galvez4, Matthew Genet4, Lijie Zhai2, Kristen L. Lauing2, Mary F. Mulcahy1,4,9,10, John P. Hayes1,5, David D. Odell1,6, Craig Horbinski1,7, Srinadh Komanduri8, Marie-Pier Tetreault8, Kwang-Youn A. Kim3 and Victoria M. Villaflor1,4,9,10
1Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, 60611 IL, USA
2Department of Neurological Surgery, Feinberg School of Medicine of Northwestern University, Chicago, 60611 IL, USA
3Department of Preventive Medicine, Feinberg School of Medicine of Northwestern University, Chicago, 60611 IL, USA
4Department of Medicine, Feinberg School of Medicine of Northwestern University, Chicago, 60611 IL, USA
5Department of Radiation Oncology, Northwestern University, Chicago, 60611 IL, USA
6Department of Thoracic Surgery, Northwestern University, Chicago, 60611 IL, USA
7Department of Pathology, Northwestern University, Chicago, 60611 IL, USA
8Department of Gastroenterology, Northwestern University, Chicago, 60611 IL, USA
9Division of Hematology and Oncology, Northwestern University, Chicago, 60611 IL, USA
10Northwestern Medicine Developmental Therapeutics Institute, Chicago, 60611 IL, USA
Correspondence to:
Victoria M. Villaflor, email: [email protected]
Keywords: esophageal cancer; indoleamine 2,3 dioxygenase; immunotherapy; checkpoint inhibitor; the cancer genome atlas
Received: December 23, 2017 Accepted: April 04, 2018 Published: May 04, 2018
ABSTRACT
Background: Indoleamine 2,3-dioxygenase 1 (IDO1) is an enzyme with immunomodulatory properties that has emerged as a potential immunotherapeutic target in human cancer. However, the role, expression pattern, and relevance of IDO1 in esophageal cancer (EC) are poorly understood. Here, we utilize gene expression analysis of the cancer genome atlas (TCGA) and immunohistochemistry (IHC) to better understand the role and prognostic significance of IDO1 in EC.
Results: High IDO1 mRNA levels were associated with worse overall survival (OS) in both esophageal squamous cell carcinoma (SCC) (P = 0.02) and adenocarcinoma (AC) (P = 0.036). High co-expression of IDO1 and programmed death ligand 1 (PD-L1) was associated with worse OS in SCC (P = 0.0031) and AC (P = 0.0186). IHC for IDO1 in SCC showed a significant correlation with PD-L1 (P < 0.0001) and CD3ε (P < 0.0001).
Conclusions: EC with high IDO1 and PD-L1 expression is significantly correlated with decreased patient survival, and may correlate with increased T-cells. These data suggest that simultaneous inhibition of IDO1 and PD-(L)1 may overcome important barriers to T-cell mediated immune rejection of EC.
Materials and Methods: mRNA expression data from TCGA (SCC N = 87; AC N = 97). IHC in a second cohort of EC (N = 93) were stained for IDO1, PD-L1, and CD3ε, followed by light microscopic analysis.
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