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Tetanus booster, specifically administered as a combination of Tetanus and Diphtheria (Td) toxoids, is utilized in neuro-oncology as a site-preconditioning agent to enhance the efficacy of therapeutic cancer vaccines. In clinical trials led by Washington University School of Medicine and Duke University (such as the PRiME II trial, NCT05096481), the booster is administered intradermally at the vaccine site prior to the delivery of tumor-specific antigens (e.g., the PEP-CMV peptide vaccine). This pre-conditioning induces a localized inflammatory response and increases the expression of the chemokine CCL3 (MIP-1 alpha), which promotes the recruitment and migration of dendritic cells to the draining lymph nodes. This mechanism is intended to improve the priming of T-cells against tumor antigens in patients with pediatric brain tumors, including diffuse midline glioma, high-grade glioma, medulloblastoma, and ependymoma.
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