ISOTOPE: ISOform-guided prediction of epiTOPEs in cancer

Immunotherapies provide effective treatments for previously untreatable tumors and identifying tumor-specific epitopes can help elucidate the molecular determinants of therapy response. Here, we describe a pipeline, ISOTOPE (ISOform-guided prediction of epiTOPEs In Cancer), for the comprehensive identification of tumor-specific splicing-derived epitopes. Using RNA sequencing and mass spectrometry for MHC-I associated proteins, ISOTOPE identified neoepitopes from tumor-specific splicing events that are potentially presented by MHC-I complexes. Analysis of multiple samples indicates that splicing alterations may affect the production of self-epitopes and generate more candidate neoepitopes than somatic mutations. Although there was no difference in the number of splicing-derived neoepitopes between responders and non-responders to immune therapy, higher MHC-I binding affinity was associated with a positive response. Our analyses highlight the diversity of the immunogenic impacts of tumor-specific splicing alterations and the importance of studying splicing alterations to fully characterize tumors in the context of immunotherapies. ISOTOPE is available at Author summary Immune cells have the ability to attack tumor cells upon the identification of tumor-specific peptides, i.e., epitopes, that are presented by the major histocompatibility complex (MHC). New cancer immunotherapies that help trigger this process provide a promising therapeutic strategy. One crucial aspect for their success is the ability to determine the molecular properties of a tumor that are informative about the effectiveness of the therapy. Alterations in the way genes are processed to express RNA molecules could lead to the production of new peptides, with some of them potentially being presented as tumor epitopes and facilitate the attack of immune cells. It is therefore essential to facilitate the identification of these splicing-derived epitopes. In this work, we describe a computational pipeline that performs a comprehensive identification of splicing alterations in a tumor and the potential epitopes that they would produce. Analysis of tumor samples with our pipeline show that responders and non-responders to immune therapy do not show differences in the number of splicing-derived epitopes, but splicing neoepitopes have higher affinity to the MHC complex in responders. Our new pipeline facilitates the genome-scale analysis of the role of splicing alterations in shaping the molecular properties that influence response to immunotherapy. ### Competing Interest Statement The authors have declared no competing interest.