A personalized dendritic cell vaccine called ZSNeo-DC has produced promising early results in patients with newly diagnosed glioblastoma (GBM), the most aggressive form of brain cancer. In a Phase Ib trial published July 4 in Nature Communications, all 11 patients receiving the vaccine were alive at 12 months, and median progression-free survival reached 16.2 months, figures that compare favorably with historical outcomes for standard treatment alone.
The results come from a single-center, open-label trial at Beijing Tiantan Hospital, led by co-senior authors Nan Ji and Xudong Cheng. While the small, non-randomized design means the data should be interpreted cautiously, the trial provides evidence that personalized immunotherapies targeting each patient’s unique tumor mutations are feasible and potentially effective in GBM, a cancer that has proven largely resistant to checkpoint inhibitors and other immunotherapies.
How ZSNeo-DC Works
ZSNeo-DC is a form of personalized cancer vaccine. Each patient’s tumor is surgically removed and genomically sequenced to identify mutations specific to their cancer cells, known as neoantigens. Between 5 and 20 neoantigen peptides are then selected and used to “pulse” the patient’s own dendritic cells, which are the immune system’s most potent antigen-presenting cells. These loaded dendritic cells are injected intradermally near lymph nodes in the groin or armpit, where they activate T cells against the tumor neoantigens.
The approach differs from checkpoint inhibitors, which remove the brakes from T cells, and from CAR-T cell therapy, which engineers T cells to recognize a single antigen. Dendritic cell vaccines instead aim to train the patient’s own immune system to recognize and attack multiple tumor targets simultaneously, which may reduce the chance of the tumor evolving resistance through antigen loss.
The Trial Results
Eleven newly diagnosed GBM patients with IDH1/2 wild-type tumors and greater than 90 percent surgical resection were enrolled. All received standard temozolomide chemoradiation followed by ZSNeo-DC vaccinations starting at week 2 after concurrent chemoradiation, with up to eight injections per cycle.
Key efficacy results:
- Median progression-free survival (PFS): 16.2 months from surgery
- Median overall survival (OS): not yet reached
- 12-month overall survival rate: 100 percent
For context, the historic median PFS for newly diagnosed GBM treated with the standard Stupp protocol (surgery plus temozolomide chemoradiation) is approximately 6.9 months, and median OS is approximately 14.6 months. While cross-trial comparisons are unreliable, especially with only 11 patients, a PFS of 16.2 months in this small cohort is notable.
Immune monitoring showed robust neoantigen-specific T cell responses. After the third vaccination, the median increase in interferon-gamma-producing T cells was 7.2-fold (range 1.9 to 284.7); after the fifth vaccination, it reached 10.3-fold (range 0.7 to 507.0). Patients also showed an increased ratio of activated to exhausted T cells and greater clonal evenness in their T cell receptor repertoire, both parameters positively correlated with neoantigen-specific immune response and PFS.
Safety
The treatment was well tolerated. Adverse events were predominantly grade 1 or 2, with only two febrile events recorded as treatment-related. No grade 3 or higher treatment-related adverse events occurred, supporting advancement to Phase II evaluation.
The Big Caveat
The most important limitation is the trial design: a single-arm, open-label study with just 11 patients. There is no control group, which means the PFS and OS figures are compared to historical benchmarks rather than to randomized contemporaneous controls. Patients in early-phase trials are also typically healthier and more closely monitored than the average GBM patient, which can inflate survival figures.
Additionally, two of the authors, Xiaomin Ma and Xudong Cheng, are employees of ZSky BioTech, the company that manufactures ZSNeo-DC, representing a potential conflict of interest that the paper acknowledges.
The study’s authors are clear that this is a preliminary result. “These findings support Phase 2 evaluation in expanded cohorts,” they write. Whether the 12-month 100 percent survival holds in a larger, randomized trial, and whether the vaccine adds benefit on top of the standard of care rather than simply selecting for patients who were going to do well anyway, will determine whether ZSNeo-DC becomes a real option for GBM patients.
Disclosure: Based on a peer-reviewed paper in Nature Communications, published July 4, 2026. DOI: 10.1038/s41467-026-75066-w. Trial registration: NCT04968366. Open access under CC BY 4.0.