IDH1 R132H peptide vaccine

Most WHO grade 2 and 3 gliomas carry the same amino-acid change in isocitrate dehydrogenase 1: arginine 132 becomes histidine. That single substitution is both a diagnostic marker and a shared neoantigen — a mutant peptide the immune system can, in principle, see.

The vaccine is not a whole-cell product and not a personalized construct. It is one synthetic 20-mer peptide that spans the R132H mutation, given with an immune adjuvant. The aim is to present that peptide on MHC class II and recruit mutation-specific helper T cells.

Because R132H is an early, truncal event, every tumour cell is expected to keep it. That is the scientific bet: a target the glioma cannot shed without becoming a different disease.

NOA-16 was a first-in-human study of the IDH1 R132H peptide vaccine in patients with IDH1-mutant gliomas. It asked whether the construct was safe, whether it induced mutation-specific T cells, and whether those cells could be found in blood and in tumour.

The published readout is immunological rather than a survival claim. Patients mounted IDH1-specific immune responses, and the work sits behind later, larger vaccine efforts in the same mutation.

Live record on ClinicalTrials.gov →

• IDH1 R132H-mutant glioma, as used in the original protocol
• Adequate performance status and organ function
• No medical reason to avoid peptide vaccination or the chosen adjuvant

Inclusion criteria as written on the registry, trimmed. The full list, with exclusions, is on the live record.