Driving neoantigen-based cancer vaccines for personalized immunotherapy into clinic: A burdensome journey to promising land

As tumor-specific antigens, neoantigens are ideal targets for immunotherapy, and their value in the clinical application has been noted and appreciated recently. Neoantigen-based cancer vaccine is also emerging as a promising novel therapeutic modality. Tumor neoantigen vaccines work by eliciting specific autogenous immune responses via inoculation of neoantigens in cancer patients to eliminate tumors. However, despite the good clinical efficacy and great potential of neoantigen vaccines, some challenges remain to be addressed. This review aims to illustrate the generation and development of neoantigen-specific immune responses, summarize the preparation technology and recent clinical research findings of neoantigen-based cancer vaccines, analyze the main challenges faced by neoantigen vaccines and present possible solutions. This review may provide new insights and foundation for future research and development of cancer vaccines and accelerate their clinical application process, and thereby benefit more patients with advanced tumors by early interventions.