For the first time in humans, a clinical study has tested a new therapeutic concept consisting of immunotherapy vaccines adapted to the specific characteristics of individual tumors and immune systems of patients with glioblastoma, a type of very aggressive brain tumor. Vall d'Hebron has participated in this study published at https://www.nature.com/articles/s41586-018-0810-y Nature.The international and multi-center phase 1 trial GAPVAC-101 demonstrates proof-of-concept of the Glioma Actively Personalized Vaccine Consortium (GAPVAC) approach. The trial is led by Dr. Wolfgang Wick, the University of Heidelberg and the German Cancer Consortium (DKTK) and Dr. Pierre-Yves Dietrich, from the University of Geneva. Dr. Juan Sahuquillo, head of the Neurotraumatology and Neurosurgery Unit (UNINN) at the Vall d'Hebron Research Institute (VHIR), Dr. Francisco Martínez Ricarte, researcher of the same group and Dr. Jordi Rodón, associated investigator of the Early Clinical Drug Development Group at Vall d'Hebron Institute of Oncology (VHIO) and currently also a researcher at the MD Anderson Cancer Center in Texas, USA.The perspective of an actively personalized approach to the treatment of glioblastoma is getting closer, since for the first time, the viability of such a personalized form of immunotherapy has been exemplified in a clinical setting.Glioblastoma is an aggressive form of brain tumor with poor prognosis and with an ineffective therapeutic arsenal for general survival. In fact, the characteristics of the tumor, such as the low mutational load that implies that the immune system can only attack few neoantigens, has resulted in patients not being able to benefit from the latest advances in specific tumor inhibitors.The study involved 15 patients from six European hospitals, one of them from Vall d'Hebron. All had been newly diagnosed with glioblastoma and received two therapeutic vaccines in succession, the first vaccine, APVAC1, was actively personalized and targeted at non-mutated antigens. The second vaccine, APVAC2, was preferentially targeted at neo-antigens. Vaccine compositions were completely personalized for each patient based on analysis of the transcriptome, immunopeptidome and mutanome of the individuals' tumors and, for APVAC1, also based on the capacity of each patient to mount an immune response. Both vaccine types displayed favorable safety and immunogenicity.In this regard, Dr. Wolfgang Wick said that "the ability to exploit the full repertoire of tumor antigens, including non-mutated and neo-antigens, may offer more effective immunotherapies, especially for tumors with low mutational load". And, as Dr. Ugur Sahin, Chief Executive Officer of BioNTech AG and Vice Coordinator of the GAPVAC consortium, noted: "The GAPVAC consortium is one of the first groups in the world that aim to target mutations in glioblastoma to optimize drugs for each individual patient. The high immunogenicity rate of vaccine targets detected in this collaborative study indicates that even tumors with low mutational load such as glioblastomas are amenable for individualized immunotherapy".Dr. Harpreet Singh, Scientific Director of Immatics Biotechnologies GmbH and coordinator of the GAPVAC consortium, emphasizes the satisfaction "of having been able to achieve such a high degree of treatment personalization due to the ability to perform mass spectrometry, next generation sequencing, mRNA microarray, immune repertoire analysis and drug manufacturing for every patient".The GAPVAC Consortium is one of the first projects in the world to detect mutations in glioblastoma in order to optimize and develop personalized vaccines tailored to the individual needs. It is funded by the European Union (EU FP7-HEALTH Research and Innovation) and it is led by Immatics Biotechnologies GmbH (Tuebingen, Germany) and BioNTech AG (Mainz, Germany). Apart from Vall d'Hebron University Hospital, the following centers also participated in the study: the University Hospital of Heidelberg (Germany), the University Hospital of Tuebingen (Germany), the Geneva University Hospital (Switzerland), the Leiden University Medical Center (The Netherlands), the Ringhospitalet (Copenhagen, Denmark), as well as BCN Peptides (Barcelona, Spain), the Association of Cancer Immunotherapy (CIMT), the University of California San Francisco (United States), University of Southampton (United Kingdom) and Technion Institute (Haifa, Israel).The approach to brain tumors at Vall d'HebronVall d'Hebron University Hospital conducts a multidisciplinary approach to the treatment of brain tumors in both adults and children. The oncology, radiotherapy, neuroradiology, neuropathology and neurosurgery services are part of a neurooncological program that provides an integrated leading-edge treatment for patients with brain and central nervous system tumors.Translational research in neurooncology is integrated into a multidisciplinary program with a strong focus on the early development of drugs in malignant primary brain tumors, especially glioblastomas. In the same way, patients benefit from imaging and surgical techniques as well as the most innovative and effective therapeutic strategies. The neurooncological program includes a Committee of Cerebral Tumors that meets weekly to discuss and review complex cases and determines the optimum method of treatment for each specific patient.