ESMO 2026 | iNATURE: neoantigen vaccine and CLERT in refractory advanced solid tumours
Han Chong Toh, MD, National Cancer Centre Singapore, Singapore, comments on updated results from the Phase II iNATURE trial (NCT06314087), which evaluated a personalized neoantigen peptide vaccine combined with critical-lesion immuno-preserving radiotherapy (CLERT) in patients with refractory advanced solid tumors. The vaccine significantly improved progression-free survival compared with placebo, induced neoantigen-specific immune responses in most evaluable patients, and was not associated with serious vaccine-related toxicity. This interview took place at the European Society for Medical Oncology (ESMO) 2026 Congress in Madrid, Spain.
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Transcript
That was both complex and interesting. Essentially, what they tried to do was that they looked at a bunch of patients with what we call a critical lesion. So for example, when you had a tennis ball-sized liver lesion, what they would do with a clot is they either gave low-dose or high-dose radiation, and in combination with a new antigen vaccine, in the form of a peptide and an adjuvant...
That was both complex and interesting. Essentially, what they tried to do was that they looked at a bunch of patients with what we call a critical lesion. So for example, when you had a tennis ball-sized liver lesion, what they would do with a clot is they either gave low-dose or high-dose radiation, and in combination with a new antigen vaccine, in the form of a peptide and an adjuvant. And the idea is, can you have synergy or a good partnership between radiation as well as a new antigen vaccine? And the answer in their case, it seems to be yes. The study wasn’t large, and essentially they gave vaccines to 21 people. What was interesting about this study was that it was randomized so they randomized this study to people who got the vaccine and radiation and people who only got the radiation and then essentially there was a crossover design so that’s the other interesting thing so people who progressed on the arm that did not get a vaccine could then get the vaccine so that was a crossover. So two interesting things about this study were both of these. It’s an interim analysis though.
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