In conclusion, we hypothesize based on this correlative data that in esophageal cancer, use of combinatorial immune checkpoint blockade targeting IDO1 in combination with PD-(L)1 and CTLA-4 blockade may enhance the reactivation of tumor-infiltrating T-cells, decrease immunosuppressive Tregs, and therefore amplify T-cell mediated anti-tumor responses which may further improve patient outcomes with advanced esophageal cancer. Here, CTLA4 is linked to neoplasm.