Abstract Challenges in identifying tumor-rejecting neoantigens limit the use of neoantigen-based immunotherapies to treat high mutational burden tumors, such as cutaneous squamous cell carcinoma (cSCC). Most mutations in human cSCC are unique to an individual tumor. Only a small portion of human tumors share neoantigens predicted to bind MHC, supporting the need for personalized strategies. We generated transplantable cell lines, from solar UV-induced cSCC tumors, which recapitulate the UV mutational signature and driver mutations found in human disease. Depletion of CD8 and CD4 T cells revealed a dominant role for CD8 T cells and a supporting role for CD4 T cells in constraining cSCC. Vaccination with irradiated cSCC cells completely protects from tumor challenge and is dependent on CD8 T cells. Neoantigens were prioritized based on predicted binding affinity, MHC presentation and expression. IFN-γ-secreting CD8 T cells recognizing two neoantigens were present in cSCC tumors and tumor-draining lymph nodes. Prophylactic vaccination with these neoantigens constrained cSCC growth. Structural modeling of tumor-rejecting neoantigens in cSCC and other cancer models identified an increased solvent accessible surface area of the mutated residue in tumor-rejecting neoantigens compared to non-immunogenic neoantigens, which is anticipated to improve TCR recognition. This work provides a conceptual basis for consideration of TCR recognition in the prioritization of tumor-rejecting neoantigens.
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