Indoleamine 2,3-dioxygenase activity and clinical outcome following induction chemotherapy and concurrent chemoradiation in Stage III non-small cell lung cancer

摘要: Indoleamine 2,3-dioxygenase (IDO) has recently been proposed to account for tumor-induced immunosuppression by influencing the conversion of tryptophan (Trp) into kynurenine (Kyn). The objective our study was correlate IDO activity with disease outcome in non-small cell lung cancer (NSCLC) patients treated multimodal combination therapy. In a single-arm Phase II trial involving induction gemcitabine and carboplatin followed concurrent paclitaxel, 74 Gy thoracic radiation stage III NSCLC patients, plasma drawn at baseline, post-induction, post-concurrent mean Kyn/Trp ratio used as surrogate indicator activity. 33 participants were distributed follows: 15 females, 18 males; median age = 62; overall survival (OS) 22.4 (95% CI 19.3–25.1) months; progression-free (PFS) 11.5 6.7–16.3) months. baseline (4.5 ± 2.8) higher than that healthy controls (2.9 1.9, p 0.03) increased after therapy (5.2 3.2, 0.08) chemoradiation (5.8 3.9, 0.01). post-treatment radiologic responses not significantly associated any time point. No significant correlation found between ratios OS (HR 1.1, 95% 0.45–2.5) or PFS 0.74, 0.30–1.82). A post-induction chemotherapy increase portended worse 0.43, 0.19–0.95, 0.037) 0.47, 0.22–1.0, 0.055). This observed transcription may be means tumors evade immunosurveillance.