Researchers developed a personalized genomic vaccine for use in patients who have undergone curative-intent surgery or autologous stem cell transplant and for whom there is a greater than 30% chance for recurrence. For a study, they identified candidate neoantigens following sequencing of tumor and germline DNA and RNA and use of the OpenVax custom computation pipeline. the OpenVax pipeline identified an average of 67.1 neoantigens/patient within 15 patients enrolled; only two patients did not have an adequate number of neoantigens identified to synthesize 10 peptides. Thirteen of the patients (10 with solid tumors and three with multiple myeloma) received the vaccine; 11 received all 10 doses. The vaccine was well tolerated; in 31% of patients, there were grade 1 injection site reactions. One patient was lost to follow-up; the median progression-free survival was 618 days from the time of surgery or transplant. Four patients remained without evidence of disease, with a mean follow-up of 925 days; four are receiving subsequent lines of therapy and four have died (two with documented recurrence).
