10 | See next page for caption. Nature Medicine Article https://doi.org/10.1038/s41591-024-02894-yExtended Data Fig. 10 | Patient #11 – Case Study. a, Change in target lesion from baseline (%) evaluated by RECIST 1.1 and tumor imaging scans at various treatment time points. Liver lesion (red arrows); Adrenal lesion (yellow arrows). b, TCR frequencies (%) of 25 expanded T cell clones at pre- or post-treatment in the periphery or in the target lesion (liver). c , PBMCs (3 × 10^5/per well) were stimulated with vaccine-encoded epitopes at the concentration of 10 µg/mL for 18–24 hours. Cells were evaluated for the presence of vaccine-induced neoantigen-specific responses prior to and post-personalized GNOS-PV02 vaccination using an interferon IFNγ ELISPOT assay without cytokine stimulation. The bar indicates the mean SFU of n = 3 individual technical replicates ± SD per group. d, Neoantigen-specific T cell activation was evaluated by stimulating patient-derived PBMCs (week 9) with DMSO, PROS1, or OBSCN peptides ex vivo by intracellular cytokine staining. e , Venn diagram of neoantigens identified in the liver (day 0) and adrenal lesions (week 54) by RNA/DNA sequencing. f, Monitoring of the dynamic expression of liver- or adrenal-specific targets collected over 50 weeks by ctDNA analysis. g , T cell infiltration/activation biomarkers are evaluated at pre-treatment and post-treatment (liver lesion), and from the adrenal lesion (week 54). The T cell suppressor, IDO1, is separated from the other markers with a dashed line. The significance between evaluated stacked gene expression groups was tested by a two-tailed, Mann-Whitney statistical analysis. β ≥ ≥ α Φ γ α Φ γ α γ α