Is there a cancer vaccine Brian could look into

Let me provide guidance based on trusted medical sources while considering Brian's specific case details from the clinical summary:

According to the NCCN Guidelines and NCI recommendations, there are currently no approved therapeutic cancer vaccines specifically for pancreatic adenocarcinoma. However, given Brian's molecular profile from the document, particularly his:

• High PDL1 expression
• MSS (Microsatellite Stable) status
• Immune Desert microenvironment type

The American Society of Clinical Oncology (ASCO) guidelines suggest that patients with metastatic pancreatic cancer may be candidates for clinical trials investigating novel immunotherapy approaches, which could include vaccine studies.

Based on the National Cancer Institute's current clinical trials database, while there are some experimental vaccine trials in pancreatic cancer, any recommendations would need to consider Brian's specific situation:

• His metastatic disease status
• Recent progression on FOLFIRINOX + RMC-6236
• His unique molecular profile including the RAF1 fusion

Important recommendation: Brian should discuss potential immunotherapy or vaccine trial options with his oncology team, particularly since he's already engaged with multiple major cancer centers (Columbia, NYU Langone, MSK) as noted in the clinical summary. His care team can best evaluate his eligibility for any available vaccine trials considering his complete clinical picture.

Remember: This information should be used for discussion with healthcare providers only, as clinical trial eligibility and treatment decisions must be made by his medical team.