Actively personalized vaccination trial for newly diagnosed glioblastoma
Abstract
Patients with glioblastoma currently do not sufficiently benefit from recent breakthroughs in cancer treatment that use checkpoint inhibitors 1,2. For treatments using checkpoint inhibitors to be successful, a high mutational load and responses to neoepitopes are thought to be essential 3. There is limited intratumoural infiltration of immune cells 4 in glioblastoma and these tumours contain only 30-50 non-synonymous mutations 5. Exploitation of the full repertoire of tumour antigens-that is, both unmutated antigens and neoepitopes-may offer more effective immunotherapies, especially for tumours with a low mutational load. Here, in the phase I trial GAPVAC-101 of the Glioma Actively Personalized Vaccine Consortium (GAPVAC), we integrated highly individualized vaccinations with both types of tumour antigens into standard care to optimally exploit the limited target space for patients with newly diagnosed glioblastoma. Fifteen patients with glioblastomas positive for human leukocyte antigen (HLA)-A*02:01 or HLA-A*24:02 were treated with a vaccine (APVAC1) derived from a premanufactured library of unmutated antigens followed by treatment with APVAC2, which preferentially targeted neoepitopes. Personalization was based on mutations and analyses of the transcriptomes and immunopeptidomes of the individual tumours. The GAPVAC approach was feasible and vaccines that had poly-ICLC (polyriboinosinic-polyribocytidylic acid-poly-L-lysine carboxymethylcellulose) and granulocyte-macrophage colony-stimulating factor as adjuvants displayed favourable safety and strong immunogenicity. Unmutated APVAC1 antigens elicited sustained responses of central memory CD8+ T cells. APVAC2 induced predominantly CD4+ T cell responses of T helper 1 type against predicted neoepitopes.
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Both the GAPVAC-101 and IMA950 immunotherapeutics were well tolerated and induced epitope-specific CD8+ T-cell responses.
“Both immunotherapeutics, which shared some peptides, were well tolerated and induced epitope-specific CD8+ T-cell responses [14, 15].”
From Preclinical development of an mRNA-based multiepitope immunotherapeutic for glioblastoma (2025) · cites this paper as [14]
The epitopes encoded by CVGBM have previously induced T-cell responses in patients with GBM when given as peptide-based immunotherapeutics in the GAPVAC-101 or IMA950 studies.
“The epitopes encoded by CVGBM have previously induced T-cell responses in the GAPVAC-101 or IMA950 studies in patients with GBM when given as peptide-based immunotherapeutics in combination with adjuvants [14, 15].”
From Preclinical development of an mRNA-based multiepitope immunotherapeutic for glioblastoma (2025) · cites this paper as [14]
CVGBM encodes eight epitopes that are frequently presented on the surface of GBM tumour samples.
“CVGBM encodes eight epitopes that are frequently presented on the surface of GBM tumour samples and have induced immune responses in previous clinical trials as peptide-based immunotherapeutics [14, 15].”
From Preclinical development of an mRNA-based multiepitope immunotherapeutic for glioblastoma (2025) · cites this paper as [14]
The eight CVGBM-encoded epitopes have induced immune responses in previous clinical trials as peptide-based immunotherapeutics.
“CVGBM encodes eight epitopes that are frequently presented on the surface of GBM tumour samples and have induced immune responses in previous clinical trials as peptide-based immunotherapeutics [14, 15].”
From Preclinical development of an mRNA-based multiepitope immunotherapeutic for glioblastoma (2025) · cites this paper as [14]
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Preclinical development of an mRNA-based multiepitope immunotherapeutic for glioblastoma
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“Two examples are the Phase I GAPVAC-101 study [14] and the Phase I/II IMA950 study [15], which tested peptide-based immunotherapeutics containing epitopes from unmutated TAAs that are either over-expressed or over-presented in GBM.”
Influential
- Authors
- Hilf, N., Kuttruff-Coqui, S., Frenzel, K., Bukur, V., Stevanović, S., Gouttefangeas, C., Platten, M., Tabatabai, G., Dutoit, V., van der Burg, S. H., thor Straten, P., Martínez-Ricarte, F., Ponsati, B., Okada, H., Lassen, U., Admon, A., Ottensmeier, C. H., Ulges, A., Kreiter, S., von Deimling, A., Skardelly, M., Migliorini, D., Kroep, J. R., Idorn, M., Rodon, J., Piró, J., Poulsen, H. S., Shraibman, B., McCann, K., Mendrzyk, R., Löwer, M., Stieglbauer, M., Britten, C. M., Capper, D., Welters, M. J. P., Sahuquillo, J., Kiesel, K., Derhovanessian, E., Rusch, E., Bunse, L., Song, C., Heesch, S., Wagner, C., Kemmer-Brück, A., Ludwig, J., Castle, J. C., Schoor, O., Tadmor, A. D., Green, E., Fritsche, J., Meyer, M., Pawlowski, N., Dorner, S., Hoffgaard, F., Rössler, B., Maurer, D., Weinschenk, T., Reinhardt, C., Huber, C., Rammensee, H.-G., Singh-Jasuja, H., Sahin, U., Dietrich, P.-Y., & Wick, W.
- Affiliations
- Immatics Biotechnologies (Germany) (DE)
- BioNTech (Germany) (DE)
- German Cancer Research Center (DE)
- University of California, San Francisco (US)
- Rigshospitalet (DK)
- Technion – Israel Institute of Technology (IL)
- University of Southampton (GB)
- Universitätsklinikum Tübingen (DE)
- University Hospital of Geneva (CH)
- Leiden University Medical Center (NL)
- University of Copenhagen (DK)
- The University of Texas MD Anderson Cancer Center (US)
- University of Tübingen (DE)
- GlaxoSmithKline (United Kingdom) (GB)
- Vall d'Hebron Hospital Universitari (ES)
- Agenus (United States) (US)
- Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Wick, Wolfgang
- ORCID
- Hilf, Norbert
- Kuttruff-Coqui, Sabrina
- Stevanović, Stefan
- Gouttefangeas, Cécile
- Platten, Michael
- Tabatabai, Ghazaleh
- Ponsati, Berta
- Okada, Hideho
- Lassen, Ulrik
- Admon, Arie
- Ottensmeier, Christian H.
- Kreiter, Sebastian
- Skardelly, Marco
- Migliorini, Denis
- Kroep, Judith R.
- Idorn, Manja
- Rodon, Jordi
- Poulsen, Hans S.
- McCann, Katy
- Mendrzyk, Regina
- Britten, Cedrik M.
- Capper, David
- Welters, Marij J. P.
- Sahuquillo, Juan
- Bunse, Lukas
- Wagner, Claudia
- Castle, John C.
- Schoor, Oliver
- Tadmor, Arbel D.
- Green, Edward
- Fritsche, Jens
- Hoffgaard, Franziska
- Maurer, Dominik
- Weinschenk, Toni
- Reinhardt, Carsten
- Rammensee, Hans-Georg
- Wick, Wolfgang
- Venue
- Nature
- Published
- 2018-12-19
- Volume
- 565
- Issue
- 7738
- Pages
- 240-245
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- OpenAlex
- W2904210127
- Cited by
- 938
- References
- 58
- Citations by year
- 2026: 76 · 2025: 108 · 2024: 102 · 2023: 120 · 2022: 142 · 2021: 157 · 2020: 153 · 2019: 77 · 2018: 2 · 2015: 1
- FWCI
- 55.70
- Type
- journal article
- Language
- en
- Update notices
- correction (2019-02-07)
- Open access
- closed
- Licence
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion)
- Funders
- Cancer Research UK (15951)
- Medical Research Council (MR/P024351/1)
- Topics
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Keywords
- glioblastoma, personalized cancer vaccines, neoantigens, peptide vaccine, immunopeptidome, tumor transcriptome, HLA-A*0201, HLA-A*24:02, GM-CSF adjuvant, CD8+ T cell responses, CD4+ T cell responses, immunotherapy
- MeSH terms
- Adult, Aged, Antigens, Neoplasm, Female, Glioblastoma, T-Lymphocytes, Helper-Inducer, Humans, Immunologic Memory, Male, Middle Aged, HLA-A Antigens, Treatment Outcome, CD8-Positive T-Lymphocytes, Epitopes, T-Lymphocyte, Cancer Vaccines, Precision Medicine
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