ReviewMedical oncology (Northwood, London, England)2026
Mechanism of neoantigen generation and advances in neoantigen-based immunotherapies in colorectal cancer.
Review in Medical oncology (Northwood, London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. Conventional therapeutic modalities-such as surgery, chemotherapy, and radiotherapy-yield suboptimal outcomes in advanced or recurrent disease, while immune checkpoint inhibitors demonstrate durable clinical benefit almost exclusively in the microsatellite instability-high (MSI-H) subset, which constitutes only ~ 15% of CRC cases. This stark therapeutic gap underscores an unmet medical need for novel, mechanism-driven immunotherapies. Tumor neoantigens-immunogenic peptides arising from somatic mutations and exclusively presented on malignant cells-represent highly promising targets for precision immunotherapy owing to their strict tumor-restricted expression and negligible risk of on-target, off-tumor toxicity. This review outlines the molecular mechanisms driving neoantigen generation in CRC, including frameshift mutations, single-nucleotide variants, alternative RNA splicing, and circular RNA-derived epitopes. We further delineate the immunological cascade by which these neoantigens are processed, presented via MHC molecules, and recognized by antigen-specific CD8
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