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Awake-101 is an investigational microbial-based immunotherapy developed by Matter Bio for the treatment of metastatic pancreatic ductal adenocarcinoma (PDAC). The therapy utilizes an attenuated strain of *Listeria monocytogenes* (LM) as a delivery vector for a tetanus toxoid (TT) recall antigen. The mechanism of action involves the bacteria selectively localizing and replicating within the immunosuppressive environment of the tumor and its metastases, where they are phagocytosed by tumor-associated macrophages and myeloid-derived suppressor cells. Once inside these cells, the *Listeria* secretes a fusion protein consisting of listeriolysin O (LLO) and the tetanus antigen. This process facilitates the recruitment and activation of pre-existing tetanus-specific memory T cells—originally generated through prior childhood vaccinations—to recognize and eliminate tumor cells. By converting the 'cold' tumor microenvironment into an immunologically 'hot' one, Awake-101 aims to provide a potent and targeted immune response against pancreatic cancer.
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