Autogene cevumeran phase 1 in resected pancreatic cancer (Memorial Sloan Kettering)

Sixteen patients were treated with atezolizumab and autogene cevumeran and 15 went on to modified FOLFIRINOX; vaccines were manufactured in real time from the resected tumours and given within three days of benchmarked times. Eight of 16 mounted high-magnitude neoantigen-specific T cells (up to 10 percent of blood T cells), half against more than one neoantigen. At 18 months median recurrence-free survival was not reached in responders against 13.4 months in non-responders (p 0.003; Nature 2023), and at a 3.2-year median follow-up the difference held (median not reached against 13.4 months; p 0.007), with vaccine-induced CD8 T cell clones estimated to live 7.7 years on average, 86 percent of clones per patient persisting at about three years, and recurrent tumours pruned of the vaccine-targeted clones (Nature 2025). Responders and non-responders had mounted equivalent immunity to a concurrent SARS-CoV-2 vaccine, arguing against a fitness confounder. The registry (NCT04161755) lists 29 participants, active but no longer recruiting, primary completion November 2026. The randomised phase 2 IMCODE003 (260 patients, adjuvant autogene cevumeran with atezolizumab and modified FOLFIRINOX against chemotherapy alone, eight UK sites) will test whether this translates into fewer relapses.