The role of therapeutic cancer vaccines in the modern immunotherapy era: State of the art with recent progress and future challenges

Therapeutic cancer vaccines may elicit robust CD4⁺ and CD8⁺ T cell responses across various cancer types and disease stages.

• Neoantigen vaccines show a favorable safety profile.
• Optimal efficacy may depend on careful selection of antigens, particularly those associated with clonal, driver mutations.
• Timely administration in early-stage or minimal residual disease settings is important to avoid immune evasion.
• The tumor microenvironment significantly influences vaccine responsiveness.
• High tumor mutational burden and inflamed tumor microenvironments are associated with stronger immune responses.
• Combining vaccines with immune checkpoint inhibitors, chemotherapy, or cytokine therapies could enhance effectiveness.

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