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**NOUS-209** is an investigational, off-the-shelf viral-vector neoantigen cancer vaccine developed by Nouscom for cancer immune interception in Lynch syndrome and treatment of mismatch repair-deficient/microsatellite instability-high tumors. It uses a heterologous prime-boost regimen comprising a Great Ape adenovirus vector and a modified vaccinia Ankara vector that encode 209 shared tumor frameshift-peptide neoantigens. The vaccine is designed to generate broad, durable neoantigen-specific T-cell responses against recurrent frameshift mutations in MSI tumors and premalignant lesions. Clinical development includes a Phase 1b/2 Lynch syndrome interception study and Phase 2 evaluation with pembrolizumab in anti-PD-1-refractory MSI-high metastatic colorectal cancer. ([clinicaltrials.gov](https://clinicaltrials.gov/study/NCT05078866))
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