A new generation of personalised cancer vaccines is taking shape through the use of neoantigen-based dendritic cell (DC) vaccines.

These vaccines aim to train the immune system to recognise tumour-specific mutations, known as neoantigens, and trigger targeted immune responses against cancer cells.

By tailoring vaccine components to the genetic profile of an individual’s tumour, neoantigen-based DC vaccines offer a personalised immunotherapy strategy that may help address the challenges of tumour heterogeneity and variable treatment response observed with conventional therapies.

Recent clinical studies across liver, lung, gastric, and ovarian cancers have shown that patient-derived DC vaccines can trigger strong, durable immune responses, delay tumour recurrence, and extend survival.

This individualised immunotherapy marks a crucial step toward precision cancer treatment.

Despite the success of immune checkpoint inhibitors in revolutionising oncology, their benefits remain limited to a small fraction of patients.

Many tumours develop resistance or evade immune detection through genetic and microenvironmental complexity.

Neoantigens - unique proteins arising from cancer-specific mutations - have emerged as ideal targets for immune attack because they exist only on tumour cells.

When these antigens are presented by dendritic cells (DCs), the body can mount a precise and powerful response against malignancies.

However, challenges such as identifying the right neoantigens, optimising vaccine delivery, and preventing immune escape remain significant.

Due to these challenges, researchers are now focusing on DC vaccines that harness patient-specific neoantigens to achieve stronger and more sustained cancer immunity.

A research team from the Chinese PLA General Hospital has published (DOI: 10.20892/j.issn.2095-3941.2025.0267) a comprehensive review in Cancer Biology & Medicine.

The study highlights global clinical progress in using neoantigens-loaded DC vaccines.

By summarising results from multiple trials, the authors reveal how these vaccines - combining precise genetic targeting with the body’s innate immune intelligence - could become a new cornerstone in personalised immunotherapy for solid tumours.

Neoantigen-based DC vaccines represent a marriage of genomics and immunology.

Researchers begin by sequencing a patient’s tumour DNA and RNA to identify mutations that produce novel antigens unseen by the immune system.

These antigens can be produced as synthetic peptides or delivered as mRNA molecules encoding the same tumour-specific mutations.

They are then loaded onto DCs - key immune sentinels that can activate T cells to recognise cancer cells.

Once reintroduced into the patient, these armed DCs travel to lymph nodes, where they activate cytotoxic T cells to seek out and eliminate tumour cells.

Clinical trials have already demonstrated encouraging outcomes.

In hepatocellular carcinoma, the Neo-DCVac-02 vaccine delayed recurrence and achieved an 84.6% one-year recurrence-free survival rate.

In advanced lung cancer, patients receiving Neo-DCVac achieved a 25% objective response rate with only mild side effects.

Other studies involving whole-tumour-lysate and mRNA-loaded DC vaccines have further confirmed strong immune activation and prolonged disease control, especially when combined with checkpoint inhibitors such as nivolumab.

Together, these findings highlight a new route to sustained antitumor immunity - training the immune system to remember and adapt to each patient’s unique cancer signature.

“DCs are nature’s most powerful messengers - they teach T cells how to recognise what doesn’t belong,” said Dr. Jianming Xu, corresponding author of the study.

“By loading them with a patient’s own tumour-specific neoantigens, we can design vaccines that are as unique as the cancer itself. This personalised approach avoids harming normal tissue, stimulates long-term immune memory, and offers hope for patients whose tumours no longer respond to standard therapies. It’s a step toward truly individualised cancer medicine.”

Looking ahead, neoantigen-based DC vaccines may reshape how solid tumours are treated.

Future strategies will likely integrate them with checkpoint inhibitors, chemotherapy, or adoptive T-cell therapy to enhance overall immune activation.

Researchers also see great promise in administering these vaccines early - after surgery or ablation - to eliminate residual cancer cells and establish lasting protection.

As sequencing, bioinformatics, and manufacturing technologies mature, large-scale clinical trials are expected to confirm their survival benefits.

Ultimately, these personalised vaccines could transform cancer care, shifting the focus from generalised treatment to a new paradigm: teaching every patient’s immune system to remember - and permanently fight - their own cancer.

Source: China Anti-Cancer Association