We treated 16 patients with atezolizumab and autogene cevumeran, then 15 patients with mFOLFIRINOX. The end points included vaccine-induced neoantigen-specific T cells by high-threshold assays, 18-month recurrence-free survival and oncologic feasibility.
After surgery, we sequentially administered atezolizumab (an anti-PD-L1 immunotherapy), autogene cevumeran (a maximum of 20 neoantigens per patient) and a modified version of a four-drug chemotherapy regimen (mFOLFIRINOX, comprising folinic acid, fluorouracil, irinotecan and oxaliplatin). Here in a phase I trial of adjuvant autogene cevumeran, an individualized neoantigen vaccine based on uridine mRNA–lipoplex nanoparticles, we synthesized mRNA neoantigen vaccines in real time from surgically resected PDAC tumours. Pancreatic ductal adenocarcinoma (PDAC) is lethal in 88% of patients 1, yet harbours mutation-derived T cell neoantigens that are suitable for vaccines 2, 3. Personalized RNA neoantigen vaccines stimulate T cells in pancreatic cancer
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