Avoid excessive or vigorous agitation; do not shake. Each vial of lyophilized GM -CSF (250 mcg/vial) should be reconstituted with 0. 43 ml of Sterile Water for Injection, USP 0.35 ml of reconstituted GM- CSF will be withdrawn, under aseptic conditions, using a hypodermic needle and syringe. Each vial of PEP IDH1M will be thawed at room temperature PEPIDH1M should fully thawed within 0.5 to 3 minutes, with no remaining visible frozen drug or particulate. The resultant solution of PEP IDH1M (0. 4 ml of 2 .0 mg/ml PEPIDH1M ) is a clear and colorless solution. The syringe with the previously withdrawn GM- CSF (0.35 ml volume containing 203 mcg GM- CSF), will be used to withdraw 0.35 mL of peptide. The aqueous peptide/GM- CSF is mixed 1:1 with 0.7 mL of Montanide ISA 51 a ccording to the manufacturer’s instructions . One mL of the mixture will be administered by intradermal injection (in divided doses) in the patient’s groin. After mixing, the PEPIDH1M/GM -CSF/Montanide mixture will contain approximately 500 mcg PEPIDH1M and 150 mcg GM- CSF in 1 mL of mixture. PEPIDH1M, GM-CSF and Montanide ISA 51 contain no antibacterial preservative, and therefore solutions prepared with Sterile Water for Injection, USP should be administered as soon as possible. The peptide mixture can be stored for not more than 6 hours at 2- 8°C and for not more than 3 hours at room temperature. Each PEP IDH1M/GM-CSF/Montanide immunization should be administered i.d. near the groin, divided into 2- 8 separate injections , as tolerated. It is recommended that the injections be given approximately 10 cm below the inguinal ligament . At each administration session, half of the immunization mixture will be given on the right groin and half on the left groin . Vaccine injections must be performed using an appropriate needle for intradermal administration. Following administration of the PEP IDH1M vaccine , the patient should be retained for obs ervation for a minimum of 30 minutes. 10.5 Compliance and Accountability Upon receipt from the manufacture the PEP IDH1M and the GM- CSF/Montanide will be stored in the investigational pharmacy in a temperature controlled, locked access controlled storage unit. All drug transfers, receipts, and disposals are recorded in the Web- based drug accountability system . The vaccine will be signed out and dis tributed by the investigational pharmac ist. The Duke investigational pharmacy personnel use safe medication practices to reduce the risk of medication errors and adverse events when setting up study drug procedures . They are clearly labeled with the identi ty of the study drug and other control numbers . 10.6 Disposal and Destruction Unused drug will be autoclaved. 11 SUBJECT ELIGIBILITY 11.1 Inclusion Criteria 1. Age ≥ 18 years .