Single AA substitutions increase the stimulatory effect of D-neopeptides. Comparison of the stimulatory strengths of N-class I-peptides (A and B) or N-class II-peptides (C and D) and their corresponding D-neopeptides by conservative (A, C) or nonconservative (B, D) AA substitution to TILs. Five replicate wells were tested for proliferation, and responses were depicted as SI. E, Comparison of the expression levels of activation markers CD69 and CD25 as well as cytotoxicity marker granzyme B on/in CD4+ TILs after stimulation with N-class II-peptides and their corresponding D-neopeptides. Five replicate wells were set up for each condition, and cells were collected and pooled from replicate wells for testing. F, Comparison of the cytotoxicity of TILs to tumor cells after stimulation with N-class II-peptide and D-class II-neopeptide pools for 5 days. Three replicate wells were set up for each condition. (#) indicates the peptide that was used in the first to fourth vaccinations. Data are expressed as mean ± SEM, and P values were determined using an unpaired t test.