# Neoantigen

Source: https://onco.cc/terms/neoantigen/  
OnCo record `neoantigen` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A protein fragment created by a tumour mutation that the immune system has never seen before, so it can attack it without harming normal cells.

## Summary

Arise from missense mutations, frameshifts, fusions, and splice variants; must be processed and presented on the patient's HLA. Predicted computationally (binding affinity, expression, clonality). The targets of personalised mRNA vaccines and neoantigen-specific TCR-T; higher TMB means more candidates.

## Fields

- Kind: Term
- Last checked: 2026-09-04
- Also known as: neoantigens

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Neoantigen
- Wikipedia: https://en.wikipedia.org/wiki/Neoantigen

## Connected records

- technologies: [Personalised neoantigen (mRNA) vaccines](https://onco.cc/technologies/neoantigen-mrna-vaccine/), [TCR-T cell therapy](https://onco.cc/technologies/tcr-t/)
- drugs: [Intismeran autogene](https://onco.cc/drugs/intismeran-autogene/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma](https://onco.cc/cancers/msi-high-pdac/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- key papers: [Association of distinct mutational signatures with correlates of increased immune activity in pancreatic ductal adenocarcinoma](https://onco.cc/key-papers/paper-connor-mutational-signatures-immune-pancreatic-jama-oncol-2017/), [Association of high tumor mutation burden in non-small cell lung cancers with increased immune infiltration and improved clinical outcomes of PD-L1 blockade across PD-L1 expression levels](https://onco.cc/key-papers/paper-ricciuti-tmb-pd-l1-levels-jama-oncol-2022/), [Chen and Mellman 2013: the cancer-immunity cycle](https://onco.cc/key-papers/paper-chen-mellman-cancer-immunity-cycle-immunity-2013/), [Distinct patterns of somatic genome alterations in lung adenocarcinomas and squamous cell carcinomas](https://onco.cc/key-papers/paper-campbell-pan-lung-somatic-alterations-nat-genet-2016/), [First trial of a vaccine against the shared neoantigens of mismatch-repair-deficient cancers](https://onco.cc/key-papers/paper-lynch-frameshift-vaccine-ccr-2020/), [Genetic mechanisms of immune evasion in colorectal cancer](https://onco.cc/key-papers/paper-grasso-immune-evasion-colorectal-cancer-discov-2018/), [Genomic correlates of immune-cell infiltrates in colorectal carcinoma](https://onco.cc/key-papers/paper-giannakis-genomic-correlates-immune-colorectal-cell-rep-2016/), [Identification of unique neoantigen qualities in long-term survivors of pancreatic cancer](https://onco.cc/key-papers/paper-balachandran-neoantigen-quality-long-term-survivors-nature-2017/), [Integrative analyses of colorectal cancer show Immunoscore is a stronger predictor of patient survival than microsatellite instability](https://onco.cc/key-papers/paper-mlecnik-immunoscore-msi-colorectal-immunity-2016/), [KEYNOTE-942: a personalised mRNA cancer vaccine plus pembrolizumab after melanoma surgery](https://onco.cc/key-papers/paper-keynote-942-lancet-2024/), [Le 2015: PD-1 blockade works in tumours with mismatch-repair deficiency, whatever the organ](https://onco.cc/key-papers/paper-le-mmr-deficiency-pd1-nejm-2015/), [Le 2017: mismatch-repair deficiency predicts response to PD-1 blockade across twelve tumour types, leading to the first tissue-agnostic drug approval](https://onco.cc/key-papers/paper-le-mmr-deficiency-science-2017/), [Molecular determinants of response to anti-PD-1 and anti-PD-L1 blockade in patients with non-small-cell lung cancer profiled with targeted next-generation sequencing](https://onco.cc/key-papers/paper-rizvi-targeted-ngs-immunotherapy-determinants-jco-2018/), [Rizvi 2015: the mutational landscape determines who responds to PD-1 blockade in lung cancer](https://onco.cc/key-papers/paper-rizvi-mutational-landscape-pd1-science-2015/), [RNA neoantigen vaccines prime long-lived CD8+ T cells in pancreatic cancer](https://onco.cc/key-papers/paper-sethna-rna-neoantigen-vaccine-long-lived-t-cells-nature-2025/), [Rojas 2023: a personalised mRNA vaccine trained T cells against each patient's pancreatic cancer, and those who responded stayed cancer-free longer](https://onco.cc/key-papers/paper-rojas-mrna-neoantigen-vaccine-pancreatic-nature-2023/), [Somatic POLE proofreading domain mutation, immune response, and prognosis in colorectal cancer](https://onco.cc/key-papers/paper-domingo-somatic-pole-proofreading-colorectal-lancet-gastro-2016/), [Thorsson 2018: the immune landscape of cancer across 10,000 tumours](https://onco.cc/key-papers/paper-thorsson-immune-landscape-of-cancer-immunity-2018/), [TRACERx first 100: tracking how lung cancers evolve, and how chromosomal chaos predicts relapse](https://onco.cc/key-papers/paper-tracerx-100-nejm-2017/)
- roadmaps: [Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question](https://onco.cc/roadmaps/pancreatic-roadmap/)
- ideas: [A frameshift neoantigen vaccine for Lynch syndrome carriers as the first preventive cancer vaccine approval](https://onco.cc/ideas/idea-moon-lynch-vaccine-phase3/), [A randomised trial of a shared-antigen vaccine to prevent Lynch syndrome cancers](https://onco.cc/ideas/idea-prev-lynch-frameshift-vaccine-rct/), [Antibodies that see mutant KRAS and p53 fragments displayed on the cell surface](https://onco.cc/ideas/idea-bio1-pmhc-bispecifics-public-drivers/), [Check whether a tumour can still show itself to the immune system](https://onco.cc/ideas/idea-bio2-antigen-presentation-triage/), [Personalised cancer vaccines at commodity cost through fully automated manufacturing](https://onco.cc/ideas/idea-moon-neoantigen-vaccines-at-scale/), [Personalised vaccines given only when the blood test turns positive](https://onco.cc/ideas/idea-bio2-mrd-triggered-neoantigen-vaccine/), [Select microsatellite stable patients for immunotherapy by a measured immune biomarker, not by how many treatments they have already failed](https://onco.cc/ideas/idea-crc-mss-immunotherapy-by-biomarker-not-by-line/), [Shared splice-derived neoantigens as off-the-shelf vaccine targets](https://onco.cc/ideas/idea-splice-neoantigens/), [Vaccinate against the resistance mutation before it takes over](https://onco.cc/ideas/idea-bio1-resistance-mutation-vaccine/), [Vaccines aimed only at mutations shared by every tumour cell](https://onco.cc/ideas/idea-bio1-clonal-neoantigen-vaccines/), [What makes a neoantigen actually immunogenic?](https://onco.cc/ideas/idea-neoantigen-immunogenicity-rules/)
- companies: [Nouscom](https://onco.cc/companies/nouscom/), [Serova](https://onco.cc/companies/serova/)
- institutions: [Comprehensive Cancer Center Tübingen-Stuttgart](https://onco.cc/institutions/ccc-tuebingen/), [Lausanne University Hospital (CHUV) / Ludwig Institute Lausanne](https://onco.cc/institutions/chuv-lausanne/), [Leiden University Medical Center](https://onco.cc/institutions/lumc-leiden/), [Siteman Cancer Center, Washington University](https://onco.cc/institutions/wustl-siteman/), [University Cancer Center Mainz (UCT Mainz) / Universitätsmedizin Mainz](https://onco.cc/institutions/uct-mainz/), [University College London Hospitals / UCL Cancer Institute](https://onco.cc/institutions/uclh/), [Weizmann Institute of Science](https://onco.cc/institutions/weizmann/)
- people: [Kellie N. Smith](https://onco.cc/people/kellie-smith/), [Malachi Griffith](https://onco.cc/people/malachi-griffith/), [Nina Bhardwaj](https://onco.cc/people/nina-bhardwaj/), [Robert D. Schreiber](https://onco.cc/people/robert-schreiber/), [Timothy A. Chan](https://onco.cc/people/timothy-chan/), [Ton Schumacher](https://onco.cc/people/ton-schumacher/), [Yardena Samuels](https://onco.cc/people/yardena-samuels/)
- bottlenecks: [Cold tumours and the immunosuppressive microenvironment](https://onco.cc/bottlenecks/b-tme-immunosuppression/)
- pathways: [Antigen presentation & immune editing](https://onco.cc/pathways/antigen-presentation-immunoediting/), [Mismatch repair & microsatellite instability](https://onco.cc/pathways/mismatch-repair-msi/), [Mutagenesis & mutational signatures](https://onco.cc/pathways/mutagenesis-signatures/), [RNA splicing](https://onco.cc/pathways/rna-splicing/), [The cancer-immunity cycle](https://onco.cc/pathways/cancer-immunity-cycle/)
- terms: [Antigen](https://onco.cc/terms/antigen/), [Driver and passenger mutations: the refined somatic mutation theory](https://onco.cc/terms/driver-passenger-model/), [Epitope](https://onco.cc/terms/epitope/), [Immune surveillance and cancer immunoediting](https://onco.cc/terms/immune-surveillance-immunoediting/), [Immunotherapy](https://onco.cc/terms/immunotherapy-term/), [T cell](https://onco.cc/terms/t-cell/)
- biomarkers: [TMB-high (tumour mutational burden >= 10 mutations per megabase)](https://onco.cc/biomarkers/tmb-high/)

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JSON: https://onco.cc/api/v1/entities/neoantigen.json