Phase I clinical study of personalized peptide vaccination combined with radiotherapy for advanced hepatocellular carcinoma

Figure 1 Selection personalized peptide from the peptide candidate library by peptide-specific IFN-γ production assay in consideration of the pre-existing host immunity. ^aP < 0.05, ^bP < 0.01.

Figure 2 Time schedule of collection of peripheral blood mononuclear cells and transfusion of DC-CTL. PPV: Personalized peptide vaccination; DC: dendritic cells; CTL: Cytotoxic lymphocytes; PBMC: Peripheral blood mononuclear cells.

Figure 3 Changes of alpha-fetoprotein levels in patients 1-6 before and after treament. A: AFP levels of patients 1 and 2; B: AFP levels of patients 3 and 4; C: AFP levels of patients 5 and 6. AFP: Alpha-fetoprotein.

Figure 4 Treatment outcome of patient 1. The liver mass within and out of the radiation field were both significantly decreased in size after treatment with a combination of radiotherapy and PPV-DC-CTL. AFP had a significant decline as well.

Figure 5 Treatment outcome of patient 4. Patient 4 was a case with tumor metastasis in T4 vertebra and the lung. After treatment with a combination of radiotherapy and PPV-DC-CTL, AFP had a significant decline and chest pain was relieved.

Figure 6 Cellular immune responses specific to the treatment. CD3⁺, CD8⁺ cytotoxic T lymphocytes and NK cells were increased after CTL transfusion in most cases, suggesting the possibility of immune activation. Other lymphocyte subsets had no significant changes. NK: Natural killer; PR: Partial response; SD: Stable disease; PD: Progressive disease.