Predicting Neoantigen Immunogenicity from <i>In Vivo</i> Immune Editing

Abstract Neoantigen immunogenicity prediction is fundamental to personalized cancer vaccines, tumor-infiltrating lymphocyte (TIL) therapy, and TCR-T cell engineering. Existing computational predictors rely primarily on in-vitro correlates of peptide presentation or models trained against assay-based reactivity, and they are typically validated within a single therapeutic setting. We reasoned that the most direct evidence of neoantigen immunogenicity is longitudinal in-vivo elimination: under immune checkpoint blockade (ICB), subclones bearing recognized neoantigens are selectively depleted over time. Here, we present the Neoantigen Elimination Model (NEMo), a two-compartment (CD8 and CD4) machine learning classifier trained on the in-vivo editing (IVE) of neoantigens across serially sequenced, ICB-treated tumors. By using mechanistically inspired NeoPrecis features designed to capture determinants of immunogenicity beyond MHC binding affinity, NEMo recovered assay-confirmed immunogenic neoantigens across four independent, unseen clinical settings—pre-existing immunogenicity screening, personalized cancer vaccines, TIL therapy, and a radiotherapy±ICB ctDNA cohort—and stratified progression-free survival more strongly than ELISPOT-confirmed reactivity. The editing signal further revealed an immune-evasion architecture in which oncogenic drivers and neoantigens restricted to lost or silenced HLA alleles are systematically spared from editing. Highlights - NEMo learns in-vivo immunoediting to prioritize immunogenic targets - NEMo outperforms existing tools across four independent clinical settings - Complete subclonal coverage and presentation integrity predict survival - Clonal oncogenic driver status and HLA damage spare neoantigens from editing