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New Video: Study shows cancer vaccine blocks tumor progression at early lesion stage - VUMC News

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LifeFlight began using the larger twin engine BK-117 craft, which is capable of simultaneous transport of two patients, in 1986. (photo by John Howser) &lt;/p&gt; " data-medium-file="https://vumc-reporter.s3.amazonaws.com/uploads/SEE-F.P.O_7-450x291.jpg" data-large-file="https://vumc-reporter.s3.amazonaws.com/uploads/SEE-F.P.O_7-790x512.jpg" /> <h6 class="featured-story__category">Emergency &amp; Trauma</h6> <h3 class="featured-story__title">The LifeFlight legacy: 40 years in 40 photos</h3> </a> </div> </div> </div> </header> <main id="primary" class="site-main"> <header class="single-post-header"> <div class="single-post-header__eyebrow"> <a href="https://news.vumc.org/section/cancer/" class="single-post-header__category"> Cancer </a> <h3 class="single-post-header__date"> October 7, 2024 </h3> </div> <h1>New Video: Study shows cancer vaccine blocks tumor progression at early lesion stage</h1> <div class="single-post-header__excerpt"> <p>Senior author Mary Philip, MD, PhD, associate director of the Vanderbilt Institute for Infection, Immunology and Inflammation, talks about her Journal for ImmunoTherapy of Cancer study.<br /> The findings support further vaccine investigation to make long-term, progression-free survival a reality for more cancer patients.</p> </div> </header> <div class="content-with-sidebar"> <article id="post-368711" class="post-368711 post type-post status-publish format-standard has-post-thumbnail hentry category-cancer tag-department-of-medicine tag-division-of-hematology-and-oncology tag-journal-for-immunotherapy-of-cancer tag-mary-philip tag-vanderbilt-institute-for-infection-immunology-and-inflammation-vi4 vumc_highlight-all-news vumc_highlight-research location-vanderbilt-ingram-cancer-center content_type-news-releases"> <div class="post-opening"> <div class="post-opening__share-print share-print"> <div class="share-print__share"> <h5>Share:</h5> <a href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F" target="_blank" rel="noopener noreferrer" class="share-link share-link--facebook"> <span class="screen-reader-text">Share on Facebook</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/facebook_blue.png" alt="Facebook" /> </a> <a href="https://bsky.app/intent/compose/?text=New+Video%3A+Study+shows+cancer+vaccine+blocks+tumor+progression+at+early+lesion+stage https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F" target="_blank" rel="noopener noreferrer" class="share-link share-link--bsky"> <span class="screen-reader-text">Share on Bsky</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/bluesky_blue.png" alt="Bluesky" /> </a> <a href="https://x.com/intent/tweet?url=https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F&text=New+Video%3A+Study+shows+cancer+vaccine+blocks+tumor+progression+at+early+lesion+stage" target="_blank" rel="noopener noreferrer" class="share-link share-link--twitter"> <span class="screen-reader-text">Share on X</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/x_blue.png" alt="X" /> </a> <a href="https://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F&title=New+Video%3A+Study+shows+cancer+vaccine+blocks+tumor+progression+at+early+lesion+stage&source=VUMC+News" target="_blank" rel="noopener noreferrer" class="share-link share-link--linkedin"> <span class="screen-reader-text">Share on LinkedIn</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/linkedin_blue.png" alt="LinkedIn" /> </a> <a href="mailto:?subject=New+Video%3A+Study+shows+cancer+vaccine+blocks+tumor+progression+at+early+lesion+stage&body=https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F" target="_blank" rel="noopener noreferrer" class="share-link share-link--email"> <span class="screen-reader-text">Share via Email</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/email_blue.png" alt="Email" /> </a> </div> <div class="share-print__print"> <h5>Print:</h5> <a href="javascript:window.print()" class="post-opening__print-link"> <span class="screen-reader-text">Print this article</span> <img src="https://news.vumc.org/wp-content/themes/vumc-news/images/social/print_blue.png" alt="Print" /> </a> </div> </div> <div class="post-opening__byline"> By: Tom Wilemon </div> </div> <div class="entry-content clearfix"> <!-- The script tag should live in the head of your page if at all possible --> <script type="text/javascript" async src="https://play.vidyard.com/embed/v4.js"></script> <!-- Put this wherever you would like your player to appear --> <img decoding="async" style="width: 100%; margin: auto; display: block;" class="vidyard-player-embed" src="https://play.vidyard.com/kwN1dJgqp7kqaJvnLGys51.jpg" data-uuid="kwN1dJgqp7kqaJvnLGys51" data-v="4" data-type="inline" /> <figcaption class="wp-element-caption">Senior author Mary Philip, MD, PhD, associate director of the Vanderbilt Institute for Infection, Immunology and Inflammation, talks about her Journal for ImmunoTherapy of Cancer study that found an existing cancer vaccine that had little success in clinical trials for patients with advanced tumors could potentially have efficacy if administered earlier in the treatment cycle.</figcaption></figure> <p>A cancer vaccine that had little success in clinical trials for patients with advanced tumors could potentially have efficacy if administered earlier in the treatment cycle, according to a study from Vanderbilt researchers.&nbsp;&nbsp;</p> <p>The investigators demonstrated in a mouse model that the cancer vaccine can block tumor progression if administered when the lesions are at an early stage.&nbsp;</p> <p>Results of the study, which were published Oct. 3 in the <em><a href="https://jitc.bmj.com/content/12/10/e009129">Journal for ImmunoTherapy of Cancer</a></em>, revealed that tumor-specific T cell populations are present in mice with early-stage lesions and can be therapeutically exploited by vaccination, but mice with advanced tumors do not retain these cells. The inquiry by the Vanderbilt researchers differed from most cancer vaccine studies, which have focused on patients with advanced tumors.</p> <p>The findings support further vaccine investigation to make long-term, progression-free survival a reality for more cancer patients, said the study’s senior author <a href="https://www.vumc.org/viiii/person/mary-philip-md-phd">Mary Philip</a>, MD, PhD, associate director of the <a href="http://vumc.org/viiii/">Vanderbilt Institute for Infection, Immunology and Inflammation</a>.&nbsp;</p> <p>With the development and widespread use of mRNA vaccines for COVID-19, there is growing excitement about using personalized vaccines to treat and prevent cancer.&nbsp;&nbsp;</p> <div class="wp-block-image"> <figure class="alignright size-full"><img decoding="async" width="300" height="290" data-attachment-id="368712" data-permalink="https://news.vumc.org/2024/10/07/study-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage/philip_mary/" data-orig-file="https://vumc-reporter.s3.amazonaws.com/uploads/Philip_Mary.jpg" data-orig-size="300,290" data-comments-opened="0" data-image-meta="{&quot;aperture&quot;:&quot;4.5&quot;,&quot;credit&quot;:&quot;Steve Green&quot;,&quot;camera&quot;:&quot;Canon EOS-1D X&quot;,&quot;caption&quot;:&quot;9-26-2018 - Photos of Mary Philip in her lab at A3314 in Medical Center North, with some of her staff. (Vanderbilt University \/ Steve Green)&quot;,&quot;created_timestamp&quot;:&quot;1540829916&quot;,&quot;copyright&quot;:&quot;Vanderbilt University &amp; Medical Center&quot;,&quot;focal_length&quot;:&quot;27&quot;,&quot;iso&quot;:&quot;320&quot;,&quot;shutter_speed&quot;:&quot;0.01&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}" data-image-title="Philip_Mary" data-image-description="" data-image-caption="&lt;p&gt;Mary Philip, MD, PhD&lt;/p&gt; " data-medium-file="https://vumc-reporter.s3.amazonaws.com/uploads/Philip_Mary.jpg" data-large-file="https://vumc-reporter.s3.amazonaws.com/uploads/Philip_Mary.jpg" src="https://vumc-reporter.s3.amazonaws.com/uploads/Philip_Mary.jpg" alt="Mary Philip, MD, PhD" class="wp-image-368712"/><figcaption class="wp-element-caption">Mary Philip, MD, PhD</figcaption></figure></div> <p>“Our study suggests that the timing of vaccination is important,” said Philip, assistant professor of Medicine in the Division of Hematology and Oncology, and assistant professor of Pathology, Microbiology and Immunology.&nbsp;“A unique feature of our study is that these mice are at high, essentially 100% risk of developing cancers, so the fact that a single immunization at the right time can give lifelong protection is pretty striking. There are not many cancer studies where mice have been followed so long after vaccination and remain tumor free for two years.”&nbsp;</p> <p>The study also showed that early treatment with a cancer vaccine blocked tumor progression when immune checkpoint blockade (ICB) therapies were ineffective. ICB therapies are approved for treating advanced cancers, but only a subset of patients with certain types of cancer achieve durable remission with them.&nbsp;&nbsp;</p> <p>“ICB works by taking the brakes off T cells, but if the T cells have never been properly activated, they are like cars without gas, and ICB doesn’t work,” Philip said. “The vaccination boosts the T cells into a functional state so that they can eliminate early cancer cells.”&nbsp;&nbsp;</p> <p>The researchers developed a clinically relevant genetic cancer mouse model in which hepatocytes (liver cells) sporadically undergo oncogenic transformation. They found that mice with early lesions retained a progenitor TCF1+tumor-specific CD8 T cell population, but not mice with advanced tumors.</p> <p>Philip and colleagues investigated a vaccine previously tested in human clinical trials for advanced cancers. This vaccine uses a gram-positive intracellular bacterium that induces strong CD4 and CD8 T cell responses, and it is engineered to express the tumor epitope, which boosts tumor-reactive T cells. All mice that received vaccination at an early stage remained tumor free, but the vaccine failed to slow liver tumor progression when administered at a later point (age 100 days).&nbsp;&nbsp;</p> <p>The researchers concluded that the presence of a progenitor TCF1+tumor-specific CD8 T cell population is necessary for cancer vaccines to be effective.&nbsp;</p> <p>The study’s first author is Carlos Detrés Román, a Vanderbilt University graduate student working in Philip’s lab. Other authors are Megan Erwin, Michael Rudloff, MD, PhD, Frank Revetta, Kristen Murray, Natalie Favret, Jessica Roetman, Joseph Roland, PhD, and Kay Washington, MD, PhD.&nbsp;The digital object identifier for the study is 10.1136/jitc-2024-009129.&nbsp;</p> <p>The National Institutes of Health supported the research with grants R37CA263614, T32CA009592, T32GM008554, T32AR059039, T32GM007347 and P30DK058404.&nbsp;</p> <p></p> <div id='jp-relatedposts' class='jp-relatedposts' > <h3 class="jp-relatedposts-headline"><em>Related</em></h3> </div> </div> <div class="share-bar share-print"> <div class="share-print__share"> <h5>Share:</h5> <a href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fnews.vumc.org%2F2024%2F10%2F07%2Fstudy-shows-cancer-vaccine-blocks-tumor-progression-at-early-lesion-stage%2F" target="_blank" rel="noopener noreferrer" class="share-link share-link--facebook"> <span class="screen-reader-text">Share on Facebook</span> <img 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class="pojo-a11y-toolbar-inner"> <p class="pojo-a11y-toolbar-title">Accessibility Tools</p> <ul class="pojo-a11y-toolbar-items pojo-a11y-tools"> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-resize-font pojo-a11y-btn-resize-plus" data-action="resize-plus" data-action-group="resize" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Increase Text</title><path fill="currentColor" d="M256 200v16c0 4.25-3.75 8-8 8h-56v56c0 4.25-3.75 8-8 8h-16c-4.25 0-8-3.75-8-8v-56h-56c-4.25 0-8-3.75-8-8v-16c0-4.25 3.75-8 8-8h56v-56c0-4.25 3.75-8 8-8h16c4.25 0 8 3.75 8 8v56h56c4.25 0 8 3.75 8 8zM288 208c0-61.75-50.25-112-112-112s-112 50.25-112 112 50.25 112 112 112 112-50.25 112-112zM416 416c0 17.75-14.25 32-32 32-8.5 0-16.75-3.5-22.5-9.5l-85.75-85.5c-29.25 20.25-64.25 31-99.75 31-97.25 0-176-78.75-176-176s78.75-176 176-176 176 78.75 176 176c0 35.5-10.75 70.5-31 99.75l85.75 85.75c5.75 5.75 9.25 14 9.25 22.5z"></path></svg></span><span class="pojo-a11y-toolbar-text">Increase Text</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-resize-font pojo-a11y-btn-resize-minus" data-action="resize-minus" data-action-group="resize" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Decrease Text</title><path fill="currentColor" d="M256 200v16c0 4.25-3.75 8-8 8h-144c-4.25 0-8-3.75-8-8v-16c0-4.25 3.75-8 8-8h144c4.25 0 8 3.75 8 8zM288 208c0-61.75-50.25-112-112-112s-112 50.25-112 112 50.25 112 112 112 112-50.25 112-112zM416 416c0 17.75-14.25 32-32 32-8.5 0-16.75-3.5-22.5-9.5l-85.75-85.5c-29.25 20.25-64.25 31-99.75 31-97.25 0-176-78.75-176-176s78.75-176 176-176 176 78.75 176 176c0 35.5-10.75 70.5-31 99.75l85.75 85.75c5.75 5.75 9.25 14 9.25 22.5z"></path></svg></span><span class="pojo-a11y-toolbar-text">Decrease Text</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-background-group pojo-a11y-btn-grayscale" data-action="grayscale" data-action-group="schema" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Grayscale</title><path fill="currentColor" d="M15.75 384h-15.75v-352h15.75v352zM31.5 383.75h-8v-351.75h8v351.75zM55 383.75h-7.75v-351.75h7.75v351.75zM94.25 383.75h-7.75v-351.75h7.75v351.75zM133.5 383.75h-15.5v-351.75h15.5v351.75zM165 383.75h-7.75v-351.75h7.75v351.75zM180.75 383.75h-7.75v-351.75h7.75v351.75zM196.5 383.75h-7.75v-351.75h7.75v351.75zM235.75 383.75h-15.75v-351.75h15.75v351.75zM275 383.75h-15.75v-351.75h15.75v351.75zM306.5 383.75h-15.75v-351.75h15.75v351.75zM338 383.75h-15.75v-351.75h15.75v351.75zM361.5 383.75h-15.75v-351.75h15.75v351.75zM408.75 383.75h-23.5v-351.75h23.5v351.75zM424.5 383.75h-8v-351.75h8v351.75zM448 384h-15.75v-352h15.75v352z"></path></svg></span><span class="pojo-a11y-toolbar-text">Grayscale</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-background-group pojo-a11y-btn-high-contrast" data-action="high-contrast" data-action-group="schema" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>High Contrast</title><path fill="currentColor" d="M192 360v-272c-75 0-136 61-136 136s61 136 136 136zM384 224c0 106-86 192-192 192s-192-86-192-192 86-192 192-192 192 86 192 192z"></path></svg></span><span class="pojo-a11y-toolbar-text">High Contrast</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-background-group pojo-a11y-btn-negative-contrast" data-action="negative-contrast" data-action-group="schema" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Negative Contrast</title><path fill="currentColor" d="M416 240c-23.75-36.75-56.25-68.25-95.25-88.25 10 17 15.25 36.5 15.25 56.25 0 61.75-50.25 112-112 112s-112-50.25-112-112c0-19.75 5.25-39.25 15.25-56.25-39 20-71.5 51.5-95.25 88.25 42.75 66 111.75 112 192 112s149.25-46 192-112zM236 144c0-6.5-5.5-12-12-12-41.75 0-76 34.25-76 76 0 6.5 5.5 12 12 12s12-5.5 12-12c0-28.5 23.5-52 52-52 6.5 0 12-5.5 12-12zM448 240c0 6.25-2 12-5 17.25-46 75.75-130.25 126.75-219 126.75s-173-51.25-219-126.75c-3-5.25-5-11-5-17.25s2-12 5-17.25c46-75.5 130.25-126.75 219-126.75s173 51.25 219 126.75c3 5.25 5 11 5 17.25z"></path></svg></span><span class="pojo-a11y-toolbar-text">Negative Contrast</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-background-group pojo-a11y-btn-light-background" data-action="light-background" data-action-group="schema" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Light Background</title><path fill="currentColor" d="M184 144c0 4.25-3.75 8-8 8s-8-3.75-8-8c0-17.25-26.75-24-40-24-4.25 0-8-3.75-8-8s3.75-8 8-8c23.25 0 56 12.25 56 40zM224 144c0-50-50.75-80-96-80s-96 30-96 80c0 16 6.5 32.75 17 45 4.75 5.5 10.25 10.75 15.25 16.5 17.75 21.25 32.75 46.25 35.25 74.5h57c2.5-28.25 17.5-53.25 35.25-74.5 5-5.75 10.5-11 15.25-16.5 10.5-12.25 17-29 17-45zM256 144c0 25.75-8.5 48-25.75 67s-40 45.75-42 72.5c7.25 4.25 11.75 12.25 11.75 20.5 0 6-2.25 11.75-6.25 16 4 4.25 6.25 10 6.25 16 0 8.25-4.25 15.75-11.25 20.25 2 3.5 3.25 7.75 3.25 11.75 0 16.25-12.75 24-27.25 24-6.5 14.5-21 24-36.75 24s-30.25-9.5-36.75-24c-14.5 0-27.25-7.75-27.25-24 0-4 1.25-8.25 3.25-11.75-7-4.5-11.25-12-11.25-20.25 0-6 2.25-11.75 6.25-16-4-4.25-6.25-10-6.25-16 0-8.25 4.5-16.25 11.75-20.5-2-26.75-24.75-53.5-42-72.5s-25.75-41.25-25.75-67c0-68 64.75-112 128-112s128 44 128 112z"></path></svg></span><span class="pojo-a11y-toolbar-text">Light Background</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-links-underline" data-action="links-underline" data-action-group="toggle" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Links Underline</title><path fill="currentColor" d="M364 304c0-6.5-2.5-12.5-7-17l-52-52c-4.5-4.5-10.75-7-17-7-7.25 0-13 2.75-18 8 8.25 8.25 18 15.25 18 28 0 13.25-10.75 24-24 24-12.75 0-19.75-9.75-28-18-5.25 5-8.25 10.75-8.25 18.25 0 6.25 2.5 12.5 7 17l51.5 51.75c4.5 4.5 10.75 6.75 17 6.75s12.5-2.25 17-6.5l36.75-36.5c4.5-4.5 7-10.5 7-16.75zM188.25 127.75c0-6.25-2.5-12.5-7-17l-51.5-51.75c-4.5-4.5-10.75-7-17-7s-12.5 2.5-17 6.75l-36.75 36.5c-4.5 4.5-7 10.5-7 16.75 0 6.5 2.5 12.5 7 17l52 52c4.5 4.5 10.75 6.75 17 6.75 7.25 0 13-2.5 18-7.75-8.25-8.25-18-15.25-18-28 0-13.25 10.75-24 24-24 12.75 0 19.75 9.75 28 18 5.25-5 8.25-10.75 8.25-18.25zM412 304c0 19-7.75 37.5-21.25 50.75l-36.75 36.5c-13.5 13.5-31.75 20.75-50.75 20.75-19.25 0-37.5-7.5-51-21.25l-51.5-51.75c-13.5-13.5-20.75-31.75-20.75-50.75 0-19.75 8-38.5 22-52.25l-22-22c-13.75 14-32.25 22-52 22-19 0-37.5-7.5-51-21l-52-52c-13.75-13.75-21-31.75-21-51 0-19 7.75-37.5 21.25-50.75l36.75-36.5c13.5-13.5 31.75-20.75 50.75-20.75 19.25 0 37.5 7.5 51 21.25l51.5 51.75c13.5 13.5 20.75 31.75 20.75 50.75 0 19.75-8 38.5-22 52.25l22 22c13.75-14 32.25-22 52-22 19 0 37.5 7.5 51 21l52 52c13.75 13.75 21 31.75 21 51z"></path></svg></span><span class="pojo-a11y-toolbar-text">Links Underline</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-readable-font" data-action="readable-font" data-action-group="toggle" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Readable Font</title><path fill="currentColor" d="M181.25 139.75l-42.5 112.5c24.75 0.25 49.5 1 74.25 1 4.75 0 9.5-0.25 14.25-0.5-13-38-28.25-76.75-46-113zM0 416l0.5-19.75c23.5-7.25 49-2.25 59.5-29.25l59.25-154 70-181h32c1 1.75 2 3.5 2.75 5.25l51.25 120c18.75 44.25 36 89 55 133 11.25 26 20 52.75 32.5 78.25 1.75 4 5.25 11.5 8.75 14.25 8.25 6.5 31.25 8 43 12.5 0.75 4.75 1.5 9.5 1.5 14.25 0 2.25-0.25 4.25-0.25 6.5-31.75 0-63.5-4-95.25-4-32.75 0-65.5 2.75-98.25 3.75 0-6.5 0.25-13 1-19.5l32.75-7c6.75-1.5 20-3.25 20-12.5 0-9-32.25-83.25-36.25-93.5l-112.5-0.5c-6.5 14.5-31.75 80-31.75 89.5 0 19.25 36.75 20 51 22 0.25 4.75 0.25 9.5 0.25 14.5 0 2.25-0.25 4.5-0.5 6.75-29 0-58.25-5-87.25-5-3.5 0-8.5 1.5-12 2-15.75 2.75-31.25 3.5-47 3.5z"></path></svg></span><span class="pojo-a11y-toolbar-text">Readable Font</span> </a> </li> <li class="pojo-a11y-toolbar-item"> <a href="#" class="pojo-a11y-toolbar-link pojo-a11y-btn-reset" data-action="reset" tabindex="-1" role="button"> <span class="pojo-a11y-toolbar-icon"><svg version="1.1" xmlns="http://www.w3.org/2000/svg" width="1em" viewBox="0 0 448 448"><title>Reset</title><path fill="currentColor" d="M384 224c0 105.75-86.25 192-192 192-57.25 0-111.25-25.25-147.75-69.25-2.5-3.25-2.25-8 0.5-10.75l34.25-34.5c1.75-1.5 4-2.25 6.25-2.25 2.25 0.25 4.5 1.25 5.75 3 24.5 31.75 61.25 49.75 101 49.75 70.5 0 128-57.5 128-128s-57.5-128-128-128c-32.75 0-63.75 12.5-87 34.25l34.25 34.5c4.75 4.5 6 11.5 3.5 17.25-2.5 6-8.25 10-14.75 10h-112c-8.75 0-16-7.25-16-16v-112c0-6.5 4-12.25 10-14.75 5.75-2.5 12.75-1.25 17.25 3.5l32.5 32.25c35.25-33.25 83-53 132.25-53 105.75 0 192 86.25 192 192z"></path></svg></span> <span class="pojo-a11y-toolbar-text">Reset</span> </a> </li> </ul> </div> </div> </nav> </body> </html>

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