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Abstract
Personalized mRNA neoantigen vaccines aim to generate immune responses against specific tumor mutations in cancer patients.
- Therapeutic activity relies on neoantigen selection, immune priming, and the functionality of immune responses in a suppressive tumor environment.
- Immune checkpoint blockade may enhance the effectiveness of these vaccines by alleviating inhibitory signals that limit T-cell responses.
- Key factors influencing vaccine effectiveness include neoantigen clonality, antigen presentation, tumor heterogeneity, and immune escape mechanisms.
- Current evaluations encompass clinical outcomes in melanoma, non-small cell lung cancer, and pancreatic ductal adenocarcinoma.
- Investigational therapies include intismeran autogene and autogene cevumeran, which encode patient-specific neoantigens.
- Identifying determinants of immune priming and therapeutic efficacy could guide biomarker-based patient selection and future treatment combinations.
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