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Neoantigen hierarchy. Most tumors present dominant and subdominant antigens on the surface. (i) PD-L1 on tumors suppresses neoantigen-reactive T cells. (ii) Immune checkpoint blockage preferentially reinvigorates dominant antigens. The subdominant neoantigens are also discovered by a highly sensitive neoantigen screen. Subdominant neoantigen-specific T cells can be activated by vaccines and dominant ones and can attack tumors.
