{
  "abstract": "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+ 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+ and CD8+ 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+ T cells.",
  "authors": [
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Ana Maia"
    },
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Juliane Schuhmacher"
    },
    {
      "affiliations": [
        "Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Silvio Nadalin"
    },
    {
      "affiliations": [
        "Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany",
        "Cluster of Excellence iFIT (EXC2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, University of Tübingen, Tübingen, Germany"
      ],
      "name": "Alfred Königsrainer"
    },
    {
      "affiliations": [
        "Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany",
        "Department of General, Visceral and Thoracic Surgery, Oberschwabenklinik gGmbH, St. Elisabethen-Klinikum, Ravensburg, Germany"
      ],
      "name": "Karolin Thiel"
    },
    {
      "affiliations": [
        "Cluster of Excellence iFIT (EXC2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, University of Tübingen, Tübingen, Germany",
        "Institute of Immunology, Department of Peptide-based Immunotherapy, University and University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Annika Nelde"
    },
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Raphael S Zinser"
    },
    {
      "affiliations": [
        "Institute of Medical Genetics and Applied Genomics, University Hospital Tübingen, Tübingen, Germany",
        "German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), partner site Tübingen, Heidelberg, Germany"
      ],
      "name": "Christopher Schroeder"
    },
    {
      "affiliations": [
        "Institute of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Sven Mattern"
    },
    {
      "affiliations": [
        "Institute of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Stephan Singer"
    },
    {
      "affiliations": [
        "Institute of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Hans Bösmüller"
    },
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany",
        "Cluster of Excellence iFIT (EXC2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, University of Tübingen, Tübingen, Germany",
        "German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), partner site Tübingen, Heidelberg, Germany"
      ],
      "name": "Hans-Georg Rammensee"
    },
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany",
        "Cluster of Excellence iFIT (EXC2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, University of Tübingen, Tübingen, Germany",
        "German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), partner site Tübingen, Heidelberg, Germany",
        "Institute for Clinical and Experimental Transfusion Medicine (IKET), University Hospital Tübingen, Tübingen, Germany"
      ],
      "name": "Markus W Löffler"
    },
    {
      "affiliations": [
        "Institute of Immunology, University and University Hospital Tübingen, Tübingen, Germany",
        "Cluster of Excellence iFIT (EXC2180) ‘Image-Guided and Functionally Instructed Tumor Therapies’, University of Tübingen, Tübingen, Germany",
        "German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), partner site Tübingen, Heidelberg, Germany"
      ],
      "name": "Cécile Gouttefangeas"
    }
  ],
  "title": "Exceptional tumor-free survival of a patient with metastatic intrahepatic cholangiocarcinoma after surgery and personalized peptide vaccination: revisiting a striking case",
  "uid": "c47c8cdb-8d8a-5095-91b7-c00e39fe5db3"
}