Preclinical data support ongoing clinical trials testing IDO inhibitors as a treatment for cancer

Inhibitors of indoleamine 2,3-dioxygenase (IDO) are being assessed in clinical trials as a potential treatment for recurrent or refractory solid tumors. Clear genetic rationale for these trials, together with evidence that primary and metastatic lung tumors might be particularly susceptible to the drugs, is now reported in a preclinical study published in Cancer Discovery, a journal of the American Association for Cancer Research.

"Our data provide preclinical genetic validation for the ongoing clinical trials testing IDO inhibitors in cancer patients," said Alexander Muller, Ph.D., associate professor at Lankenau Institute for Medical Research in Wynnewood, Pa. "We also believe that our results indicate that these drugs could have particular impact in patients with and lung metastases, conditions for which there is an urgent, unmet need for new ."

The ongoing clinical trials were initiated based on pharmacological studies that indicated that IDO inhibitors can enhance the effectiveness of other therapies in mouse models of cancer. to support the concept was lacking. Muller and his colleagues, therefore, set out to determine the effect of disrupting the IDO gene on tumor development in mice.

"It was very important to us to use models of disease as physiologically relevant as possible," he said. "We chose the KRAS-induced lung carcinoma model as our model of primary disease since tumors can be induced selectively in the lung and are driven by mutations in a gene known to be affected in approximately 20 percent of nonsmall cell lung cancers. We modeled metastatic disease using the 4T1 mouse cell line, which very efficiently metastasizes to the lung after being engrafted in the of mice. This is one of only a few breast cancer models with the capacity to metastasize efficiently to sites affected in human ."

Genetically-induced IDO deficiency reduced lung tumor burden and improved survival in both models.

"This genetic confirmation of the importance of IDO in development is essential support for the clinical trials," said Muller. "However, we were also hoping to garner insight into the mechanisms by which IDO impacts tumor development. In this regard, our findings linking IDO to increased vascularization and modification of the inflammatory environment are critical. These data indicate that IDO has a far more expansive role in tumorigenesis than we might have thought."

Analysis of differences between the lungs of IDO-sufficient and -deficient tumor-bearing mice in the KRAS-induced model revealed that levels of the pro-inflammatory molecule IL-6 were markedly lower in the absence of IDO. Levels of this known tumor-promoting factor were also lower in the model of metastasis when IDO was absent.

Additional work in the model of metastasis indicated that IDO-potentiated IL-6 production and promoted metastasis to the lung by driving the expansion and immunosuppressive function of a population of cells known as myeloid-derived suppressor cells (MDSCs). MDSCs are well-characterized, potent inhibitors of antitumor immune responses.

"It was very satisfying to be able to experimentally close the loop and clearly define a mechanism by which IDO promotes metastatic outgrowth to the lung, at least in the 4T1 breast cancer model," said Muller. "We think that this mechanism might also link with the vascular effects of IDO. IDO promotes tumorigenesis in many different ways, and we are looking to see if we can take clinical advantage of some of these."

Muller has financial interests in the clinical development of IDO inhibitors for the purpose of treating cancer and other diseases.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

The fine line between breast cancer and normal tissues

3 hours ago

Up to 40 percent of patients undergoing breast cancer surgery require additional operations because surgeons may fail to remove all the cancerous tissue in the initial operation. However, researchers at Brigham ...

Pancreatic cancer risk not higher with diabetes Rx DPP-4i

4 hours ago

(HealthDay)—There is no increased short-term pancreatic cancer risk with dipeptidyl-peptidase-4 inhibitors (DPP-4i) compared to sulfonylureas (SU) and thiazolidinediones (TZD) for glycemic control, according ...

Good bowel cleansing is key for high-quality colonoscopy

7 hours ago

The success of a colonoscopy is closely linked to good bowel preparation, with poor bowel prep often resulting in missed precancerous lesions, according to new consensus guidelines released by the U.S. Multi-Society Task ...

New rules for anticancer vaccines

8 hours ago

Scientists have found a way to find the proverbial needle in the cancer antigen haystack, according to a report published in The Journal of Experimental Medicine.

User comments