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Published on: January 19, 2019
Radiological Features of IDO1+/PDL1+ Lung Adenocarcinoma: A Retrospective Single-institution Study
Kazuki Takada1, Gouji Toyokawa2, Tetsuzo Tagawa2
1Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan k_takada@surg2.med.kyushu-u.ac.jp.
Aim:
A combination of immune-checkpoint inhibitors that target the programmed cell death 1 (PD1)/programmed cell-death ligand 1 (PDL1) pathway and indoleamine 2,3-dioxygenase 1 (IDO1) is a promising treatment for non-small-cell lung cancer. Herein, we investigated clinical features of IDO1+/PDL1+ primary lung adenocarcinoma.
Materials And Methods:
IDO1 and PDL1 expression in 388 resected primary lung adenocarcinoma samples was evaluated using immunohistochemistry, and the radiological features of patients with IDO1+/PDL1+ lung adenocarcinoma were analyzed.
Results:
Of 388 specimens, 229 (59.0%) were IDO1+, 131 (33.8%) were PDL1+, and 109 (28.1%) were IDO1+/PDL1+ In multivariate analysis, vascular convergence and the absence of surrounding ground glass opacity were significantly associated with IDO1+/PDL1+ tumors. Fisher's exact test showed high consolidation/tumor ratio was also significantly associated with IDO1+/PDL1+ tumors. Moreover, maximum standardized uptake in 18F-fluorodeoxyglucose positron-emission tomography/computed tomography was significantly higher in patients with IDO1+/PDL1+ tumors than in those with IDO1- or PDL1- tumors.
Conclusion:
IDO1/PDL1 co-expression was significantly related to radiological invasiveness and malignancy in lung adenocarcinoma. This study may help select patients likely to benefit from combination therapy using immune-checkpoint inhibitors.
Insights
Combination therapy targeting indoleamine 2,3-dioxygenase 1 (IDO1) and programmed cell death 1 (PD1)/programmed cell-death ligand 1 (PDL1) shows promise for lung cancer. IDO1/PDL1 co-expression in lung adenocarcinoma correlates with radiological invasiveness.
Area of Science:
- Oncology
- Immunology
- Radiology
Background:
- Combination immunotherapy targeting the programmed cell death 1 (PD1)/programmed cell-death ligand 1 (PDL1) pathway and indoleamine 2,3-dioxygenase 1 (IDO1) is a promising strategy for non-small-cell lung cancer.
- Investigating the clinical and radiological features of primary lung adenocarcinoma with co-expression of IDO1 and PDL1 is crucial for optimizing treatment selection.
Purpose of the Study:
- To investigate the clinical features of primary lung adenocarcinoma samples that are positive for both indoleamine 2,3-dioxygenase 1 (IDO1) and programmed cell death ligand 1 (PDL1).
- To analyze the radiological characteristics associated with IDO1 and PDL1 co-expression in lung adenocarcinoma.
Main Methods:
- Immunohistochemistry was used to evaluate IDO1 and PDL1 expression in 388 resected primary lung adenocarcinoma samples.
- Radiological features of patients with IDO1+/PDL1+ lung adenocarcinoma were analyzed using imaging data.
Main Results:
- Of 388 specimens, 109 (28.1%) showed co-expression of IDO1 and PDL1.
- Multivariate analysis revealed significant associations between IDO1+/PDL1+ tumors and vascular convergence, absence of surrounding ground glass opacity, and a high consolidation/tumor ratio.
- Patients with IDO1+/PDL1+ tumors exhibited significantly higher maximum standardized uptake values on 18F-fluorodeoxyglucose positron-emission tomography/computed tomography.
Conclusions:
- IDO1 and PDL1 co-expression in lung adenocarcinoma is significantly related to radiological invasiveness and malignancy.
- Identifying patients with IDO1+/PDL1+ tumors may aid in selecting candidates who are likely to benefit from combination immunotherapy targeting these pathways.
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