Identification of neoantigens for immunotherapy

Background Cancer immunotherapies play an increasing role in the treatment of various tumor entities. Thereby, especially antibody therapies using immune checkpoint inhibitors have proven convincing efficacy. Neoantigens seem to be frequent targets of these therapies being exclusively expressed or presented within the tumor tissue and recognized specifically by the immune system. Methods We summarized recent insights and novel study data on neoantigens in cancer treatment based on a literature search and evaluated these with regard to clinical translation. Results This article provides an overview of our current knowledge about neoantigens. Different strategies of neoantigen identification and characterization are discussed including the implementation of artificial intelligence. Moreover, selection processes are reconsidered to identify those candidates suitable for therapeutic approaches. In addition, we address examples of applications targeting neoantigens already demonstrating promising clinical results in early clinical trials. Conclusions Neoantigens increasingly represent an essential module in immunotherapeutic strategies of tumor therapy. The successful utilization of their immunogenicity critically depends on the thoughtful selection of suitable candidates. A broader application of individualized therapies is conceivable through the successful further development of established and new high-throughput approaches.