The Clinical Application of Neoantigens in Esophageal Cancer

Abstract

Esophageal cancer (EC) is a common malignant tumor with poor prognosis, and current treatments for patients with advanced EC remain unsatisfactory. Recently, immunotherapy has been recognized as a new and promising approach for various tumors. EC cells present a high tumor mutation burden and harbor abundant tumor antigens, including tumor-associated antigens and tumor-specific antigens. The latter, also referred to as neoantigens, are immunogenic mutated peptides presented by major histocompatibility complex class I molecules. While current genomics and bioinformatics technologies have greatly facilitated the identification of tumor neoantigens, identifying individual neoantigens systematically for successful therapies remains a challenging problem. Owing to the initiation of strong, specific tumor-killing cytotoxic T cell responses, neoantigens are emerging as promising targets to develop personalized treatment and have triggered the development of cancer vaccines, adoptive T cell therapies, and combination therapies. This review aims to give a current understanding of the clinical application of neoantigens in EC and provide direction for future investigation.

Keywords: adoptive cell therapy; cancer vaccine; esophageal cancer; immunotherapy; neoantigen.

Figure 1

The major clinical application of neoantigens in esophageal cancer. Neoantigens derived from mutations in tumor cells. They can serve many purposes, including neoantigen vaccination, neoantigen specific adoptive T cell therapy, and combination therapy. Combinations of neoantigens with radiotherapy, chemotherapy, or immune checkpoint inhibitor therapy may lead to a better effect. Neoantigens induce the production of effector CD8+ T cells, thereby eliminating tumor cells.