Exceptional tumor-free survival of a patient with metastatic intrahepatic cholangiocarcinoma after surgery and personalized peptide vaccination: revisiting a striking case
Cholangiocarcinomas are rare but aggressive liver tumors of high lethality with scarce treatment options. Here we report on the follow-up of a patient diagnosed with an intrahepatic cholangiocarcinoma who experienced repeated tumor recurrences including distant metastasis, therefore facing a dismal prognosis. At present, this patient is tumor-free for more than 8 years following repeated surgery and application of two successive personalized vaccines. In-depth functional immune cell analyses revealed a dominant CD4<sup>+</sup> T-cell response against the vaccine antigens with infiltration of the tumor site and immune responses prevailing for years following the last vaccine administration. Additionally, spontaneous tumor neoantigen-specific CD4<sup>+</sup> and CD8<sup>+</sup> T-cell responses have been detected, which might have contributed to the outstanding outcome witnessed in this patient. This case report highlights vaccination strategies targeting non-mutated antigens as well as the increasingly recognized central role of antitumor CD4<sup>+</sup> T cells.
Authors
- Cécile Gouttefangeas (ORCID: https://orcid.org/0000-0002-6410-2378)
- Raphael S. Zinser
- Alfred Königsrainer (ORCID: https://orcid.org/0000-0002-2301-4080)
- Sven Mattern (ORCID: https://orcid.org/0000-0001-7362-0209)
- Silvio Nadalin (ORCID: https://orcid.org/0000-0001-8803-6670)
- Annika Nelde (ORCID: https://orcid.org/0000-0001-8504-8481)
- Markus Löffler (ORCID: https://orcid.org/0000-0003-2513-1317)
- J. Schuhmacher (ORCID: https://orcid.org/0000-0003-0553-3474)
- Christopher Schroeder (ORCID: https://orcid.org/0000-0002-9283-3012)
- Karolin Thiel (ORCID: https://orcid.org/0000-0002-7328-7589)
- Hans‐Georg Rammensee (ORCID: https://orcid.org/0000-0003-1614-2647)
- Hans Bösmüller (ORCID: https://orcid.org/0000-0002-7515-435X)
- Ana Maia (ORCID: https://orcid.org/0000-0003-1261-7211)
- Stephan Singer (ORCID: https://orcid.org/0000-0003-4775-6609)
Institutions
- German Cancer Research Center (DE)
- Heidelberg University (DE)
- Klinikum Aschaffenburg (DE)
- University Children's Hospital Tübingen (DE)
- University of Tübingen (DE)
Publication Details
- Journal
- Journal for ImmunoTherapy of Cancer
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1136/jitc-2025-012107
- Primary Topic
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Deutsche Forschungsgemeinschaft
- Eberhard Karls Universität Tübingen