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Lm-ANXA2 is a live-attenuated, double-deleted (LADD) *Listeria monocytogenes* (ΔactA ΔinlB) bacterial vector engineered to express the human Annexin A2 (ANXA2) protein. Developed primarily for the treatment of pancreatic ductal adenocarcinoma (PDAC), it functions as a cancer vaccine designed to induce a tumor antigen-specific CD8+ T cell response. ANXA2 is a pro-metastatic protein overexpressed in PDAC and other cancers. Preclinical studies demonstrate that Lm-ANXA2 can reprogram the "cold" tumor microenvironment of PDAC, increasing the infiltration of interferon-gamma (IFNγ)-expressing T cells. It is often studied in sequential combination with immune checkpoint inhibitors, such as anti-PD-1 antibodies, to overcome the immunosuppressive environment of pancreatic tumors.
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