GV1001
tertomotide, GV1001, Riavax, Tertomotide hydrochloride; hTERT 611–626 (sequence EARPALLTSRLRFIPK)
1What it is
Telomerase is the enzyme that rebuilds the ends of chromosomes. It is switched off in most adult tissue but reactivated in roughly 85–90% of human cancers, which makes it one of the few genuinely near-universal tumour antigens. GV1001 is a 16-amino-acid stretch of the enzyme's active site, long enough to be processed and presented on MHC class II by many different HLA types — an unusual and practically important property, because most peptide vaccines only work in people with a particular HLA allele.
GV1001 has an unusual second life. The same peptide is cell-penetrating and has been reported to have direct anti-inflammatory, anti-fibrotic and mitochondria-protective effects in models unrelated to its vaccine function, which is why it has been trialled in benign prostatic hyperplasia, Alzheimer's disease and chronic prostatitis as well as cancer.
2How it's thought to work
As a vaccine: GM-CSF injected first at the site draws in dendritic cells; the peptide is then taken up, processed and presented on MHC class II, expanding hTERT-specific CD4+ helper T cells. Those helper cells are intended to license and sustain CD8+ cytotoxic responses against telomerase-expressing tumour cells, and to generate durable memory.
As a direct-acting peptide: GV1001 contains a basic, cell-penetrating motif and has been reported in cell and rodent work to enter cells, localise to mitochondria, reduce reactive oxygen species, dampen NF-κB-driven inflammatory signalling and modulate steroid-receptor signalling. These mechanisms are independent of immunisation and are the stated rationale for the non-cancer trials. Evidence for them is preclinical.
3What the research shows
Advanced pancreatic cancer
Benign prostatic hyperplasia
Alzheimer's disease
Other cancers
Immune response as a surrogate
4Reported side effects and interactions
Literature-reported
injection-site reactions (erythema, induration, pruritus) in the majority, largely from GM-CSF; flu-like symptoms; fatigue. In TeloVac the serious adverse-event profile was dominated by the chemotherapy backbone, and adding GV1001 did not increase it materially. Long-term safety data outside trials is limited.Community-reported
Community use: essentially none documented.Theoretical. telomerase is expressed in stem cells, germ cells and activated lymphocytes, so autoimmune damage to those compartments was a predicted risk. It has not been observed at the doses and durations tested, but no long-term immunological follow-up exists.
Interactions. GM-CSF (used deliberately as adjuvant); cytotoxic chemotherapy may blunt or, in some schedules, enhance the response — TeloVac's sequential versus concurrent comparison was designed to test exactly this and found neither helped; corticosteroids would be expected to suppress the response.
Markers researchers commonly monitor
From trial protocols:
| Marker | Why it's watched |
|---|---|
| hTERT-specific T-cell response (ELISpot, proliferation assays, delayed-type hypersensitivity) | the pharmacodynamic readout. Note the confounding above: response status tracks baseline health as much as vaccine effect. |
| CA 19-9 | the pancreatic-cancer tumour marker used alongside imaging in TeloVac and its predecessors. |
| Overall survival and RECIST imaging | the endpoints that decided the question. |
| Regulatory T-cell fraction and myeloid-derived suppressor cells | explored as explanations for non-response. |
| International Prostate Symptom Score, prostate volume by ultrasound, PSA | the BPH trial endpoints, included here for completeness because they are a separate evidence stream. |
| CBC, CMP, liver and renal function | standard oncology safety monitoring, driven mainly by concurrent chemotherapy. |
Free for everyone. Safety information is never behind a paywall.
5Formulation and administration context
Supplied as a refrigerated solution or peptide prepared by pharmacy. The clinical procedure is specific: GM-CSF intradermally first, then GV1001 injected into the same site shortly after, with the schedule front-loaded over the first three weeks before monthly maintenance. The intradermal route and the same-site sequencing are part of the design, not incidental. No self-prepared, compounded or outpatient version exists, and no dose calculation is appropriate to publish.
6Commonly studied alongside
GM-CSF (sargramostim) as the standing adjuvant; gemcitabine and capecitabine (TeloVac backbone); checkpoint inhibitors in later exploratory work. Conceptually related: IMA901 and multi-peptide tumour vaccines (profile 236), SurVaxM (profile 234) — another vaccine against a near-universal tumour-survival antigen.
Informational cross-links. Not stack recommendations.
7Regulatory status by region
| Region | Status (checked —) |
|---|---|
| United States | Not FDA-approved; investigational only |
| European Union | Not authorised |
| United Kingdom | Not licensed. TeloVac was a UK academic phase 3 and was negative |
| Australia | Not approved |
| South Africa | Not registered with SAHPRA |
| Other | A conditional South Korean approval for a non-oncology indication has been reported in secondary sources; status, scope and whether it remains current are unconfirmed here † |
| Sport | Not listed by WADA; no performance application |
8Open questions
- Why did a class II, HLA-promiscuous vaccine against a near-universal antigen fail so completely in pancreatic cancer — tumour microenvironment, antigen presentation, or wrong disease setting?
- Are the direct, non-vaccine anti-inflammatory effects reported in cell and animal work real in humans at the doses used?
- Does the reported BPH benefit replicate independently?
9References
- 1Middleton G et al. (2014). Gemcitabine and capecitabine with or without telomerase peptide vaccine GV1001 in patients with locally advanced or metastatic pancreatic cancer (TeloVac): an open-label, randomised, phase 3 trial. Lancet Oncology. PubMed
- 2Bernhardt SL et al. (2006). Telomerase peptide vaccination of patients with non-resectable pancreatic cancer: a dose escalating phase I/II study. British Journal of Cancer. PubMed · DOI
- 3Brunsvig PF et al. (2006). Telomerase peptide vaccination: a phase I/II study in patients with non-small cell lung cancer. Cancer Immunology, Immunotherapy. PubMed · DOI
- 4Kyte JA (2009). Cancer vaccination with telomerase peptide GV1001 — review. Expert Opinion on Investigational Drugs. PubMed · DOI
- 5Koh JS et al. (2021). Efficacy and safety of GV1001 in patients with benign prostatic hyperplasia — randomised controlled trial. Journal of Urology or equivalent urology journal [verify journal before publishing]. PubMed
- 6ClinicalTrials.gov. TeloVac and related GV1001 trial records. PubMed
References are being resolved to PubMed/DOI identifiers; links search PubMed for the citation until then.
† Being confirmed by our reviewers against current sources.
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Self-reported side effects Phase 2
11Page history
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