Personalised neoantigen-based therapy in colorectal cancer

Colorectal cancer (CRC) has become one of the most common tumours with high morbidity, mortality and distinctive evolution mechanism. The neoantigens arising from the somatic mutations have become considerable treatment targets in the management of CRC. As cancer-specific aberrant peptides, neoantigens can trigger the robust host immune response and exert anti-tumour effects while minimising the emergence of adverse events commonly associated with alternative therapeutic regimens. In this review, we summarised the mechanism, generation, identification and prognostic significance of neoantigens, as well as therapeutic strategies challenges of neoantigen-based therapy in CRC. The evidence suggests that the establishment of personalised neoantigen-based therapy holds great promise as an effective treatment approach for patients with CRC. Critical Points:Peptide vaccine and neoantigens pulsed DC can trigger a robust antitumor immune response with less emergence of adverse events than other therapeutic regimens.DNA vaccine can spontaneously induce T cell response against tumor and inhibit tumor growth with low cost.mRNA vaccines have been shown to safely induce neoantigen-specific T-cell responses without MHC haplotype restriction.Personalized immunotherapy based on neoantigens will be an effective treatments for patients with CRC.image