Immunogenicity of neoantigens: From CAR-T cell to various vaccines

The recent decade has experienced phenomenal progress in recruiting cutting-edge, high-throughput genomics in cancer research, providing unprecedented insights into neoplasia-contributor mutations. Genomic data analyses enable multiplex assessments for precision medicine. For instance, the path for predicting neoantigen targets for cancer vaccines has been paved by whole-exome and RNA sequencing in combination with bioinformatics algorithms. The application of personalized vaccines, which are highly specific to individuals' tumors and aimed to provoke de novo T-cell reactions against neoantigens, is a promising approach to cancer immunotherapy. In this regard, protein-altering modifications in cancerous cells are being deciphered in light of the predicted preferential binding of the mutated peptides by the patient's immune system constituents. Herein, we first scrutinize the immunogenicity caused by neoplasm-associated antigens and then the ways of identifying and predicting cancer neoantigens. This overview also addresses developed and ongoing neoantigen-based personalized vaccines and targeted drug delivery approaches using these cancerous antigens, as well as considerations for clinical research of this novel, individualized approach to immunotherapy.