Many tumor immunotherapy efforts are focused on the generation of strong T-cell response against tumor antigens. However, strong T-cell response does not always coincide with tumor rejection, for which upregulated expression of immunoinhibitory molecules may be responsible. In this study, the treatment with heat shock protein 70 (HSP70) vaccine induced an infiltration of T cells into the tumor site as well as the expression of IFN-c and IL-2, and delayed lung metastases of tumor, but the tumor progression nonetheless occur finally. We demonstrated that B7-H1 expressed by residual tumor cells was responsible for the resistance of tumor to the therapy with HSP70 vaccine. Blockade of B7-H1 by i.v. injection pPD-1A, a plasmid encoding the extracellular domain of PD-1 (sPD-1), could reverse this resistance and enhance the therapeutic efficacy. To complement these findings, we investigated the gene expression of tumor-infiltrating lymphocytes (TILs) by Realtime PCR analysis, which revealed that the expression of T H 1 cytokines IFN-c and IL-2 by TIL in the mice treated with HSP70 vaccine in combination with sPD-1 was increased and the expression of negative regulatory molecules IL-10, TGF-b and foxp3 was decreased, demonstrating that multifunctional properties afforded by the combination therapy can effectively overcome tumor resistance and promote effective antitumor immunity. The in vivo transfection with pPD-1A could be performed as infrequently as once a week and still produce a significant antitumor effect. These findings suggest that the treatment with HSP70 vaccine followed by blockade of tumor-B7-H1 with sPD-1 may provide a promising approach for tumor immunotherapy. ' 2006 Wiley-Liss, Inc.Key words: tumor immunotherapy; tumor immunity; immune escape; gene therapy The molecular hallmark of antigens preferentially expressed by tumor cells has attracted numerous interests in the development of tumor antigen based vaccinations. The ability of heat shock proteins (HSPs) to bind cellular peptides makes them the attractive candidates for cancer vaccines. 1-5 HSPs obtained from tumors or virus-infected cells have been shown to induce CTL responses in vitro and in vivo against a variety of antigens expressed in the cells from which HSPs were purified. The immunogenicity of HSP preparations has been attributed to peptides bound to HSPs. 1 HSPs are able to chaperon antigenic peptides into antigen-presenting cells (APCs) by binding to specific receptor on APCs. 6-9 The binding of HSP-peptide complex to APCs triggers a cascade of events, including re-presentation of the chaperoned peptides by the major histocompatibility complex, secretion of proinflammatory cytokines and maturation of DCs. 10-12 These properties make HSPs-based vaccination a powerful therapeutic approach to produce tumor antigen specific T cells.Besides HSPs-based vaccination, many current attempts at harnessing the immune system are capable of eliciting strong T-cell responses against tumor antigens, as high frequencies of tumor antigen specific T cell...