Published online Dec 28, 2018. doi: 10.3748/wjg.v24.i48.5418
Peer-review started: October 14, 2018
First decision: November 8, 2018
Revised: December 11, 2018
Accepted: December 20, 2018
Article in press: December 21, 2018
Published online: December 28, 2018
Core tip: Peptide vaccines are a promising tool for colorectal cancer (CRC) treatment. Direct comparison of tumor-associated antigens (TAAs) and neoantigens reveals clear superiority of the latter for several reasons. TAAs, albeit easier to identify and even shared by many patients, did not prove effective in clinical trials. Additionally, and due to their unspecificity, they frequently trigger severe adverse events. This risk is neglectable for tumor-specific neoantigens - thus compensating for the costly and laborious identification of such antigens expressed in individual patient tumors. Intelligent modern CRC vaccines will likely combine several or even many individual neoantigen-derived peptides with immuno-chemotherapy, adjuvants or further immuno-modulators.