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A limitation of this report is that histopathologic confirmation was not available, as liver and skin biopsies were not performed because informed consent/authorization for invasive sampling could not be obtained during the acute, severe phase of illness

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The limited efficacy of peptide-based cancer vaccines is the consequence of several factors, including the identification of specific target tumor antigens, the limited immunogenicity of peptides and the highly immunosuppressive tumor microenvironment (TME)