Personalized Neoantigen Vaccines and CAR-T Cell Therapy: A New Frontier in Cancer Immunotherapy

Cancer immunotherapy has achieved groundbreaking successes with strategies like immune checkpoint inhibitors, yet many solid tumors evade immune control. Personalized neoantigen vaccines offer a new level of precision by targeting tumor-specific mutations, thereby inducing highly specific T cell responses against cancer with minimal off-target effects. Chimeric antigen receptor (CAR) T cell therapy has revolutionized treatment of hematologic malignancies, attaining remarkable remission rates, but its efficacy in solid tumors is limited by antigen heterogeneity and immunosuppressive microenvironments. Recent clinical trials of personalized neoantigen vaccines (in melanoma, pancreatic cancer, and others) demonstrate robust immunogenicity and preliminary anti-tumor activity. These findings, together with CAR-T’s potent cytotoxicity, provide a strong rationale for combined vaccine and CAR-T approaches. This paper reviews the latest clinical advancements, examines the challenges of solid tumors, proposes the synergistic integration of neoantigen vaccines with CAR-T therapy, and discusses future perspectives for this emerging frontier.