Table 2.

Main characteristics of current neoantigen vaccine platforms

Vaccine platform	Advantages	Disadvantages	Clinical trials
Synthetic long peptide vaccine	Stable in storage Low toxicity Elicit both CD8 and CD4 T-cell responses Safe Repeated vaccination possible	Requires co-administration of an appropriate adjuvant Multiple peptides need to be manufactured Immune responses may be weak and/or transient [although this appears to be more of a concern with short peptides (8–10 AA) compared with long peptides (25–30 AA)]	NCT01970358 NCT02427581 NCT02600949 NCT02721043 NCT02510950
RNA vaccine	Activation of TLR3, TLR7, TLR8 No potential for integration into the genome (cf. DNA vaccine)	Manufacture more complex Subject to RNase degradation, although modification could potentially extend the half-life	NCT02035956 NCT02316457
Dendritic cell vaccine	Dendritic cells represent the most important cell for CD8 T-cell priming Dendritic cells can be modified to express both neoantigens and costimulatory molecules	Labor intensive and high cost Requires ex vivo expansion, maturation, and activation Short half-life in vivo	NCT00683670 NCT01885702
DNA vaccine	Capable of delivery of multiple antigens in a single vaccine Flexible platform allowing molecular engineering Relatively straightforward manufacturing process that is readily scaled for personalized intervention	Limited success in humans with first generation delivery platforms, success may be dependent on electroporation Limited potential for integration into the genome	NCT02348320 NCT03122106