*2.2. Patient Eligibility*

As we wished to focus on safety and immunoreactivity to the antigens in this vaccine treatment, we enrolled patients with recurrent/progressive HGG (World Health Organization (WHO) grade III/IV glioma) including, but not limited to, glioblastoma (grade IV glioma) from April 2014 to November 2016 at Keio University Hospital (Tokyo, Japan)—resulting in a somewhat heterogenous patient cohort.

Inclusion criteria were as follows: (1) histological diagnosis of supratentorial HGG (World Health Organization (WHO) grade III or IV according to the 2007 WHO criteria) without multiple lesions or leptomeningeal dissemination; (2) patients were informed about their diagnosis; (3) HLA-A\*2402-positive status; (4) age between 16 and 79 years; (5) Eastern Cooperative Oncology performance status 0–2; (6) completion of standard treatment (surgical therapy + radiation therapy + temozolomide); (7) four-week interval from last chemotherapy or radiotherapy; (8) adequate bone-marrow, cardiac, pulmonary, and hepatic and renal functions including neutrophil ≥1000/μL, platelet count ≥50,000/μL, hemoglobin ≥8 g/dL, plasma aspartate aminotransferase and alanine aminotransferase levels ≤4 times the normal limit, plasma bilirubin levels ≤1.5 times the normal limit, plasma albumin levels ≥2.5 g/dL, and plasma creatinine levels ≤2.0 mg/dL; (9) life expectancy >3 months; (10) signature confirming informed consent. Exclusion criteria were as follows: (1) uncontrollable infection; (2) the presence of another serious disease such as uncontrolled diabetes, hepatic disorder, cardiac disease, hemorrhage/bleeding; (3) total parenteral nutrition; (4) multiple cancers; (5) myelodysplastic syndrome (MDS), MDS/myeloproliferative disease (MPD) and MPD; (6) allogenic hematopoietic stem cell transplantation; (7) severe immunological disorders (autoimmune disease, immunosuppression); (8) anaphylaxis to synthetic peptides; (9) concurrent treatment with steroids or immunosuppressive agents; (10) pregnant or breast-feeding women; (11) severe mental disorder; (12) unhealed wound; (13) decision of unsuitability by the principal investigator or the physician in charge.
