NSCLC · visit 1
Phase 3 V940 NSCLC development is active; immunopeptidomics improves neoantigen selection, while presentation defects remain a hard gate.
Wed, 19 Aug 2026 19:27:59 GMT · gpt-5.6-terra · done
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Ledger moves

openv940-nsclc-phase3Phase 3 NSCLC registry program identified; no outcome data supplied. [NCT06623422]
openimmunopeptidomics-neoantigen-selection-nsclcPatient-level functional neoantigen-selection evidence supports pipeline prioritization. [PMID:42270771]
openantigen-presentation-gating-nsclc-vaccinesResistance biology defines a selection and combination constraint. [PMID:42495623]
openmrna-neoantigen-vaccine-operational-barriersReview identifies translational constraints relevant to personalized mRNA deployment. [PMID:41984335]

Trace (unedited)

INTerpath-009 establishes a phase 3 NSCLC program testing pembrolizumab with or without intismeran autogene (V940), with platinum-doublet chemotherapy listed in the protocol. No efficacy readout is supplied. NCT06623422 Immunopeptidomics-guided selection is the strongest translational enablement signal. In 24 NSCLC tumors, donor-specific HLA presentation filtering generated functional responses in 5/6 tested patients and strong responses to 9/70 putative neoantigens. PMID:42270771 Antigen presentation competence is a gating variable. NSCLC ICI resistance is associated with MHC-I, TAP2, B2M, IFN/JAK-STAT defects, neoantigen loss, and immune-excluded states; vaccine-induced T cells will not overcome absent presentation alone. PMID:42495623 Neoantigen mRNA vaccine reviews identify manufacturing timeline, HLA diversity, tumor heterogeneity, and immune editing as implementation constraints; these are not resolved by the current clinical registry record. PMID:41984335 ```json { "leads": [ { "id": "v940-nsclc-phase3", "title": "Intismeran autogene (V940) in phase 3 NSCLC", "claim": "INTerpath-009 is a recruiting phase 3 NSCLC study of pembrolizumab with or without intismeran autogene (V940); the listed protocol includes platinum-doublet chemotherapy options and has primary completion projected for 2033.", "citations": [ "NCT06623422" ], "status": "opened" }, { "id": "immunopeptidomics-neoantigen-selection-nsclc", "title": "Immunopeptidomics-guided neoantigen selection", "claim": "In 24 NSCLC tumors, HLA-presentation-informed neoantigen selection produced functional responses in 5 of 6 tested patients; 9 of 70 putative neoantigens elicited strong responses.", "citations": [ "PMID:42270771" ], "status": "opened" }, { "id": "antigen-presentation-gating-nsclc-vaccines", "title": "Antigen-presentation competence as a vaccine-response gate", "claim": "NSCLC immune resistance includes MHC-I, TAP2, B2M, and IFN/JAK-STAT defects, neoantigen loss, and immune-excluded states; these mechanisms constrain neoantigen-vaccine activity.", "citations": [ "PMID:42495623" ], "status": "opened" }, { "id": "mrna-neoantigen-vaccine-operational-barriers", "title": "Operational constraints on personalized neoantigen mRNA vaccination", "claim": "Personalized neoantigen mRNA vaccine implementation is constrained by manufacturing timelines, HLA diversity, tumor heterogeneity, and immune editing.", "citations": [ "PMID:41984335" ], "status": "opened" } ], "candidates": [], "dossiers": [], "retired": [], "ledger_moves": [ { "action": "open", "target": "v940-nsclc-phase3", "note": "Phase 3 NSCLC registry program identified; no outcome data supplied.", "citations": [ "NCT06623422" ] }, { "action": "open", "target": "immunopeptidomics-neoantigen-selection-nsclc", "note": "Patient-level functional neoantigen-selection evidence supports pipeline prioritization.", "citations": [ "PMID:42270771" ] }, { "action": "open", "target": "antigen-presentation-gating-nsclc-vaccines", "note": "Resistance biology defines a selection and combination constraint.", "citations": [ "PMID:42495623" ] }, { "action": "open", "target": "mrna-neoantigen-vaccine-operational-barriers", "note": "Review identifies translational constraints relevant to personalized mRNA deployment.", "citations": [ "PMID:41984335" ] } ], "next_queries": [ "\"intismeran autogene\" OR V940 AND non-small cell lung cancer", "\"personalized mRNA neoantigen vaccine\" AND NSCLC AND clinical trial", "NSCLC neoantigen vaccine immunopeptidomics HLA presentation" ], "summary_line": "Phase 3 V940 NSCLC development is active; immunopeptidomics improves neoantigen selection, while presentation defects remain a hard gate." } ```

Evidence pack

18 trials
15 papers
10 targets
fetched 2026-08-19T19:27:59.822Z

Top targets

EGFR 0.888 causal/genetic (genetic=0.93, somatic=0.93)
KRAS 0.834 somatic (somatic=0.92, genetic=0.00)
ALK 0.813 somatic (somatic=0.82, genetic=0.00)
ERBB2 0.812 somatic (somatic=0.81, genetic=0.00)
ROS1 0.808 somatic (somatic=0.86, genetic=0.38)
MET 0.806 somatic (somatic=0.84, genetic=0.00)
DICER1 0.794 causal/genetic (genetic=0.86, somatic=0.84)
RET 0.775 somatic (somatic=0.76, genetic=0.00)
TP53 0.774 somatic (somatic=0.92, genetic=0.00)
BRAF 0.761 somatic (somatic=0.87, genetic=0.00)
UNREVIEWED AI-generated hypothesis for human review. Not medical advice, not a diagnosis, not a treatment recommendation. Trial records © ClinicalTrials.gov. Literature © its publishers.