# Identification of unique neoantigen qualities in long-term survivors of pancreatic cancer

Source: https://onco.cc/key-papers/paper-balachandran-neoantigen-quality-long-term-survivors-nature-2017/  
OnCo record `paper-balachandran-neoantigen-quality-long-term-survivors-nature-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The rare people who survive pancreatic cancer for years have tumours carrying both many mutation-made target proteins and plenty of killer T cells, and the quality of those targets, some resembling germ proteins, predicts long survival.

## Summary

Genetic, immunohistochemical and transcriptional immunoprofiling, computational biophysics and functional assays were used to identify T-cell antigens in long-term survivors of pancreatic cancer. Whole-exome sequencing with in silico neoantigen prediction showed that tumours with both the highest neoantigen number and the most abundant CD8 T-cell infiltrates, but neither alone, stratified the longest survival. A neoantigen quality fitness model giving greater immunogenicity to neoantigens with differential presentation and homology to infectious disease peptides identified long-term survivors in two independent datasets, whereas a quantity model did not; MUC16 neoantigens featured. Intratumoural and lasting circulating T-cell reactivity to high-quality and MUC16 neoantigens was detected, and high-quality neoantigenic clones were selectively lost on metastatic progression, consistent with immunoediting.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Nature
- Year: 2017
- DOI: 10.1038/nature24462
- Authors: Balachandran VP, Luksza M, Zhao JN, et al.
- Findings: Long-term survival required both high neoantigen number and abundant CD8 infiltrate.; A neoantigen quality model, including MUC16 neoantigens and microbial homology, predicted survival.; High-quality neoantigen clones were lost at metastasis.
- What it means: It is the proof that T cells can control pancreatic cancer in some people, and the scientific basis for the personalised neoantigen vaccines now in trials.
- Caveats: Small long-term survivor cohorts.; The fitness model is computational and not a clinical test.

## Sources

- Balachandran et al., Nature 2017: neoantigen quality in long-term survivors: https://doi.org/10.1038/nature24462
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29132146/

## Connected records

- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Personalised neoantigen (mRNA) vaccines](https://onco.cc/technologies/neoantigen-mrna-vaccine/), [Whole-exome & whole-genome sequencing](https://onco.cc/technologies/wes-wgs/)
- institutions: [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/)
- pathways: [Antigen presentation & immune editing](https://onco.cc/pathways/antigen-presentation-immunoediting/), [The cancer-immunity cycle](https://onco.cc/pathways/cancer-immunity-cycle/)
- terms: [Immune exclusion](https://onco.cc/terms/immune-exclusion/), [Neoantigen](https://onco.cc/terms/neoantigen/), [Tumour mutational burden (TMB)](https://onco.cc/terms/tmb/)
- people: [Vinod P. Balachandran](https://onco.cc/people/vinod-balachandran/)
- journals: [Nature](https://onco.cc/journals/nature/)

---
JSON: https://onco.cc/api/v1/entities/paper-balachandran-neoantigen-quality-long-term-survivors-nature-2017.json