Beneath the Surface: Neoantigens beyond Chromosomal DNA Mutations

Summary: The conventional wisdom is that the overwhelming majority of neoantigens arise from chromosomal DNA mutations; however, recent studies show that posttranscriptional and posttranslational events can also generate neoantigens. This commentary provides an overview of known and potential sources of nonchromosomal neoantigens, emerging technologies, and clinical trials that may move this field forward to redefine immunologically “hot/cold” tumors and develop next-generation immunotherapeutic approaches.