Fig. 5.

Schematic illustration of neoantigen-based cancer immunotherapy production. The individualized neoantigens are identified using blood cells and tumor tissues from patient. These patient-specific neoantigens are used to develop immunotherapies, such as cancer vaccines and ACTs. Cancer vaccines in the form of peptides, DNA or mRNA, and dendritic cells are generated and administered to the same patient. For ACTs, T cells are extracted from the peripheral blood or tumor tissues of a patient and then induced to proliferate by cytokines, monoclonal antibodies against CD3 and CD28, and other reagents. The development of neoantigen-specific T lymphocytes with neoantigen-specific targeting requires co-culturing T cells with primed APCs and genetic engineering of immune cells with TCRs or CARs. After sufficient T cell expansion, T cell products are injected into lymphodepleted patients with the hope of eliciting an immune response that attacks the tumors