Interest of adjuvant and neoadjuvant vaccination in the early stages of cancer

Therapeutic cancer vaccines aim to expand tumor-antigen–specific T lymphocytes to eliminate cancer cells selectively. Recent advances in identifying neoantigens arising from genomic mutations in tumor cells, along with progress in vaccine-platform engineering, particularly in messenger RNA technologies, have revitalized the clinical development of cancer vaccines. Promising data from clinical trials of adjuvant vaccination in early-stage disease demonstrate the interest of vaccination for preventing recurrence. In this review, we describe the immunological rationale of cancer vaccines in the early stages of cancer. We also discuss the rationale for neoadjuvant cancer vaccination in combination with cotherapy such as chemotherapy or immune checkpoint inhibitors (ICIs). • Provide an immunological rationale for adjuvant versus neoadjuvant cancer vaccine • Overview of novel combinatorial adjuvant personalized versus non-personalized cancer vaccine • Interest of perioperative cancer vaccine