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Acta Pharmacologica Sinica

Therapeutic cancer vaccines: development, challenges, and future perspectives

This review outlines the historical development of therapeutic cancer vaccines, neoantigen identification strategies, and recent progress across DNA, RNA, peptide, cellular, and viral vaccine platforms, and discusses key mechanisms shaping vaccine response and resistance, including pattern-recognition receptor signaling, dendritic cell-mediated antigen presentation, T-cell effector and memory differentiation, metabolic adaptation, epitope spreading, and tumor microenvironment remodeling, proposing that future vaccines be developed as integrated immunological systems coordinating antigen discovery, precise delivery, innate immune calibration, memory maintenance, and local immune suppression reversal.