NEOANTIGENS AND METHODS OF THEIR USE

1 - 294 . (canceled)

295 . A composition comprising:

a. a recombinant or synthetic HLA-matched neoantigenic peptide,

b. a polynucleotide encoding the recombinant neoantigenic peptide,

c. antigen presenting cells (APCs) comprising (a) or (b),

d. T cells stimulated with APCs comprising (a) or (b), or

e. a T cell receptor (TCR) that binds to an MHC: peptide complex comprising a tumor-specific neoepitope of the recombinant or synthetic HLA-matched neoantigenic peptide;

wherein the neoantigenic peptide comprises a tumor-specific neoepitope comprising a mutant amino acid sequence encoded by a sequence downstream of a frameshift mutation in a gene, and wherein:

i. the gene is selected from the group consisting of GBP3, LMAN1, NDUFC2, SEC31A, SLC35F5, TTK, EPHB2, XPOT, THAP5, and MSH3; or

ii. the gene is TGFBR2 and the frameshift is P129fs+1 or K128fs−1.

296 . The composition of claim 295 , wherein

a. the gene is GBP3 and the frameshift is T585fs−1;

b. the gene is SEC31A and the frameshift is I462fs−1;

c. the gene is SLC35F5 and the frameshift is C248fs−1;

d. the gene is TTK and the frameshift is R854fs−1;

e. the gene is EPHB2 and the frameshift is K1020fs−1;

f. the gene is XPOT and the frameshift is F126fs−1;

g. the gene is THAP5 and the frameshift is K99fs−1; or

i. the gene is MSH3 and the frameshift is K383fs−1.

297 . The composition of claim 296 , wherein

a. the gene is TGFBR2 and the tumor-specific neoepitope is ALMSAMTTS (SEQ ID NO: 1159), AMTTSSSQK (SEQ ID NO: 1160), AMTTSSSQKN (SEQ ID NO: 1161), CIMKEKKSL (SEQ ID NO: 1162), CIMKEKKSLV (SEQ ID NO: 1163), IMKEKKSL (SEQ ID NO: 1164), IMKEKKSLV (SEQ ID NO: 1165), KSLVRLSSCV (SEQ ID NO: 1166), LVRLSSCVPV (SEQ ID NO: 1167), RLSSCVPVA (SEQ ID NO: 1168), RLSSCVPVAL (SEQ ID NO: 1169), SAMTTSSSQK (SEQ ID NO: 1170), SLVRLSSCV (SEQ ID NO: 1171), VPVALMSAM (SEQ ID NO: 1172), or VRLSSCVPVA (SEQ ID NO: 1173);

b. the gene is GBP3 and the tumor-specific neoepitope is TLKKKPRDI (SEQ ID NO: 1087);

c. the gene is LMAN1 and the tumor-specific neoepitope is SLRRKYLRV (SEQ ID NO: 1097);

(d) the gene is NDUFC2 and the tumor-specific neoepitope is ITAFFLLDI (SEQ ID NO: 1117), LLYITAFFL (SEQ ID NO: 1118), LLYITAFFLL (SEQ ID NO: 1119), LYITAFFLL (SEQ ID NO: 1120), LYITAFFLLD (SEQ ID NO: 1121), or YITAFFLLDI (SEQ ID NO: 1122);

(e) the gene is SEC31A and the tumor-specific neoepitope is KKLMLLRLNL ((SEQ ID NO: 1126); KLMLLRLNL (SEQ ID NO: 1127), KLMLLRLNLR (SEQ ID NO: 1128), LLRLNLRKM (SEQ ID NO: 1129), LMLLRLNL (SEQ ID NO: 1130), LMLLRLNLRK (SEQ ID NO: 1131), LNLRKMCGPF (SEQ ID NO: 1132), MLLRLNLRK (SEQ ID NO: 1133), MLLRLNLRKM (SEQ ID NO: 1134), NLRKMCGPF (SEQ ID NO: 1135), NYCQKKLMLL (SEQ ID NO: 1136), or YCQKKLMLL (SEQ ID NO: 1137);

(f) the gene is SLC35F5 and the tumor-specific neoepitope is FALCGFWQI (SEQ ID NO: 1148);

(g) the gene is TTK and the tumor-specific neoepitope is FVMSDTTYK (SEQ ID NO: 1175), FVMSDTTYKI (SEQ ID NO: 1176), KTFEKKGEK (SEQ ID NO: 1177), LFVMSDTTYK (SEQ ID NO: 1178), MSDTTYKIY (SEQ ID NO: 1179), VMSDTTYKI (SEQ ID NO: 1180), or VMSDTTYKIY (SEQ ID NO: 1181);

(h) the gene is EPHB2 and the tumor-specific neoepitope is ILIRKAMTV (SEQ ID NO: 1085);

(i) the gene is XPOT and the neoantigenic peptide comprises at least 8 contiguous amino acids of ILTKWPKFFL (SEQ ID NO: 1182);

(j) the gene is THAP5 and the tumor-specific neoepitope is KMRKKYAQK (SEQ ID NO: 1174);

(k) the gene is MSH3 and the neoantigenic peptide comprises at least 8 contiguous amino acids of SLPQARLCLI (SEQ ID NO: 1111).

298 . The composition of claim 295 , wherein the tumor-specific neoepitope is (a) encoded by a gene of cancer cells of a human subject, (b) is expressed by the cancer cells of the human subject, (c) is not expressed by a gene of non-cancer cells of the human subject, and (d) is not encoded by the gene of the non-cancer cells.

299 . The composition of claim 295 , wherein the composition is a vaccine.

300 . The composition of claim 300 , wherein the composition is a Lynch Syndrome vaccine.

301 . The composition of claim 295 , wherein the polynucleotide encoding the recombinant neoantigenic peptide is DNA.

302 . The composition of claim 295 , wherein the polynucleotide encoding the recombinant neoantigenic peptide is a messenger RNA (mRNA).

303 . The composition of claim 295 , wherein the neoantigenic peptide is at least 50 amino acids in length.

304 . The composition of claim 295 , wherein the neoantigenic peptide is at least 100 amino acids in length.

305 . A pharmaceutical composition comprising the composition of claim 295 and a pharmaceutically acceptable carrier, excipient or diluent.

306 . The pharmaceutical composition of claim 305 , wherein the pharmaceutical composition further comprises an adjuvant.

307 . A method of treating or preventing a disease or a condition in a human subject in need thereof comprising administering to the human subject the pharmaceutical composition of claim 305 .

308 . The method of claim 307 , wherein the pharmaceutical composition is administered prophylactically.

309 . The method of claim 307 , wherein the disease or condition comprises Lynch Syndrome, colorectal cancer, stomach cancer, uterine cancer, or endometrium cancer.

310 . The method of claim 307 , wherein:

a. the gene is EPHB2 and the human subject expresses an MHC encoded by an HLA A02.01 allele;

b. the gene is GBP3 and the human subject expresses an MHC encoded by an HLA B08.01 allele;

c. the gene is LMAN1 and the human subject expresses an MHC encoded by an HLA B08.01 allele;

d. the gene is NDUFC2 and the human subject expresses an MHC encoded by an HLA A02.01 allele, an HLA B08.01 allele, or an HLA A24.02 allele;

e. the gene is SEC31A and the human subject expresses an MHC encoded by an HLA A02.01 allele, an HLA A03.01 allele, an HLA B07.02 allele, an HLA B08.01 allele, or an HLA A24.02 allele;

f the gene is SLC35F5 and the human subject expresses an MHC encoded by an HLA A02.01 allele;

g. the gene is TGFBR2 and the human subject expresses an MHC encoded by an HLA A02:01 allele, an HLA A03:01 allele, an HLA A11:01 allele, an HLA B08:01 allele, or an HLA B07:02 allele;

h. the gene is THAP5 and the human subject expresses an MHC encoded by an HLA A03.01 allele;

i. the gene is TTK and the human subject expresses an MHC encoded by an HLA A02:01 allele, an HLA A03:01 allele, or an HLA A01:01 allele;

j. the gene is XPOT and the human subject expresses an MHC encoded by an HLA A02.01 allele; or

k. the gene is MSH3 and the human subject expresses an MHC encoded by an HLA A02.01 allele or an HLA B08.01 allele.

311 . A method of treating or preventing a disease or a condition in a human subject in need thereof comprising administering to the human subject a pharmaceutical composition comprising:

a. a recombinant or synthetic HLA-matched neoantigenic peptide,

b. a polynucleotide encoding the recombinant neoantigenic peptide,

c. antigen presenting cells (APCs) comprising (a) or (b),

d. T cells stimulated with APCs comprising (a) or (b), or

e. a T cell receptor (TCR) that binds to an MHC: peptide complex comprising a tumor-specific neoepitope of the recombinant or synthetic HLA-matched neoantigenic peptide;

wherein the neoantigenic peptide comprises a tumor-specific neoepitope comprising a mutant amino acid sequence encoded by a sequence downstream of a frameshift mutation in a gene, and wherein:

i. the gene is FAM111B, and the human subject expresses an MHC encoded by an HLA A03.01 allele; or

ii. the gene is UBR5 and the human subject expresses an MHC encoded by an HLA B07:02 allele.

312 . The method of claim 311 , wherein

i. the gene is FAM111B and the frameshift is A273fs−1; or

ii. the gene is UBR5 and the frameshift is K2120fs−1.

313 . The method of claim 311 , wherein

i. the gene is FAM111B and the tumor-specific neoepitope is RMKVPLMK (SEQ ID NO: 1086); or

ii. the gene is UBR5 and the tumor-specific neoepitope is RVQNQGHLL (SEQ ID NO: 1809).

314 . The method of claim 311 , wherein the pharmaceutical composition is administered prophylactically.

315 . The method of claim 311 , wherein the disease or condition comprises Lynch Syndrome, colorectal cancer, stomach cancer, uterine cancer, or endometrium cancer.