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" To produce its vaccine, Neon first determines the genome sequences of tumor cells, identifying all of the mutant molecules they produce and dangle from their surface. These dangling molecules are antigens, and because they are the products of new, cancer-related mutations they’re called neoantigens. Injecting patients with millions of copies of the neoantigens should, in theory, trigger the immune system to produce T cells that attack the neoantigens and therefore the tumor.
Since vaccines can’t be packed with an infinite number of neoantigens, Neon has to make choices. One of the melanoma patients in its study had 50 neoantigens; another had more than 8,000. “You have to pick a needle in a haystack,” Neon CEO Hugh O’Dowd told STAT ahead of the announcement — or, more precisely, 30 needles, the number of neoantigens in its vaccine. “Not all neoantigens are created equal.”
To choose those most likely to draft effective T cells, Neon has developed an algorithm that scores them, said Dr. Richard Gaynor, president of R&D: “If you have 50 mutations you have a tough time getting 30 really good neoantigens. If you have 8,000 it’s a piece of cake” because the algorithm has so many to choose from."