Cancer vaccines: comprehensive review

Background

There has been an increasing focus on the potential of cancer vaccines as a therapeutic oncological option, aiming to harness the immune system to recognize and eliminate malignant cells. Unlike traditional therapies, vaccines exploit tumour-associated antigens and neoantigens to generate durable, tumour-specific immune responses.

Methods

This review provides a comprehensive overview of current vaccine strategies, their clinical applications, and implications for surgical oncology.

Results

Clinical trials highlight promising results in high-mutational burden cancers such as melanoma, lung, and bladder cancer, as well as in traditionally ‘cold’ tumours like pancreatic cancer. Combination strategies, particularly with checkpoint inhibitors, have shown enhanced efficacy, exemplified by messenger RNA-4157/V940 and autogene cevumeran in adjuvant settings. Off-the-shelf tumour-associated antigen vaccines offer scalability but face challenges of tolerance and limited specificity. Early data suggest vaccines may improve relapse-free survival and induce antigen spreading, broadening immune responses beyond the initial targets.

Conclusion

Cancer vaccines are poised to complement surgery and systemic therapies, particularly in the perioperative window. Their integration into multimodal treatment strategies may redefine precision oncology, offering durable disease control and improved patient outcomes.