Mutant KRAS vaccine with dual checkpoint blockade in resected pancreatic cancer: a phase I trial

A Amanda L. Huff S S. Daniel Haldar A Alexander A. Girgis H Hejia Henry Wang L Ludmila Danilova T Thatcher Heumann M Maureen Berg Y Yuxuan Wang L Lalitya Andaloori A Alexei Hernandez G Gabriella Longway B Benjamin Barrett Z Zirui Zhu E Emily Davis-Marcisak C Christopher Thoburn J James Leatherman S Sarah Mitchell J Jae W. Lee D Daniel H. Shu M Maximillian F. Konig B Brian J. Mog (Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine) J Janelle Montagne E Erin M. Coyne K Katherine Bever M Marina Baretti M Mark Yarchoan R Robert A. Anders L Luciane T. Kagohara (Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine) D Daniel Laheru A Amy M. Thomas J Jennifer Durham J Julie M. Nauroth J Jiayun Lu H Hao Wang (Division of Quantitative Sciences, Department of Oncology Johns Hopkins University School of Medicine Baltimore Maryland USA) E Elana J. Fertig (Institute for Genome Sciences, University of Maryland School of Medicine) W Won Jin Ho N Nilofer S. Azad (Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore) E Elizabeth M. Jaffee N Neeha Zaidi

Abstract

Abstract In this phase I study, we test a pooled synthetic long peptide vaccine targeting the six KRAS mutations (G12V, G12A, G12R, G12C, G12D, G13D) with ipilimumab and nivolumab in resected pancreatic adenocarcinoma. Co-primary endpoints include safety and maximal percent change of IFNγ-producing mutant KRAS T cell responses in the blood within 17 weeks. Secondary endpoints include disease-free survival, overall survival, and maximal percent change of IFNγ-producing mutant KRAS T cell responses at any time after vaccination. Vaccine-related adverse events are grade 1-2. 11/12 and 10/12 patients generate a significant increase in average T cell response to 6 mutant KRAS antigens and tumor-specific response, respectively. Immunophenotyping demonstrate Th1 CD4 central memory and effector memory T cells, and CD8 effector memory T cells at a lower frequency. The vaccine also generates cross-reactive T cells that recognize more than one mutant KRAS antigen. These findings support the safety and diverse anti-tumor immunity of mutant KRAS vaccines (NCT04117087).

Article Details

Volume / Issue Vol. 17, Issue 1
Published February 10, 2026
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (39)

A

Amanda L. Huff

S

S. Daniel Haldar

A

Alexander A. Girgis

H

Hejia Henry Wang

L

Ludmila Danilova

T

Thatcher Heumann

M

Maureen Berg

Y

Yuxuan Wang

L

Lalitya Andaloori

A

Alexei Hernandez

G

Gabriella Longway

B

Benjamin Barrett

Z

Zirui Zhu

E

Emily Davis-Marcisak

C

Christopher Thoburn

J

James Leatherman

S

Sarah Mitchell

J

Jae W. Lee

D

Daniel H. Shu

M

Maximillian F. Konig

B

Brian J. Mog

Ludwig Center for Cancer Genetics and Therapeutics and Lustgarten Laboratory, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine

J

Janelle Montagne

E

Erin M. Coyne

K

Katherine Bever

M

Marina Baretti

M

Mark Yarchoan

R

Robert A. Anders

L

Luciane T. Kagohara

Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine

D

Daniel Laheru

A

Amy M. Thomas

J

Jennifer Durham

J

Julie M. Nauroth

J

Jiayun Lu

H

Hao Wang

Division of Quantitative Sciences, Department of Oncology Johns Hopkins University School of Medicine Baltimore Maryland USA

E

Elana J. Fertig

Institute for Genome Sciences, University of Maryland School of Medicine

W

Won Jin Ho

N

Nilofer S. Azad

Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore

E

Elizabeth M. Jaffee

N

Neeha Zaidi