ML, Chun BMN, Dhillon KK et al. JAMA. Published online September 21, 2026. doi:10.1001/jama.2026.15540
Abstract
Importance Advances in tumor immunology and vaccine technology are reshaping cancer vaccine development after decades of limited clinical success. More than 2000 immunogenic tumor proteins or antigens have been identified, the types of immune responses required for tumor eradication have been defined, and safe and effective vaccine delivery technologies have been developed. This progress has renewed clinical investigation of cancer vaccines for multiple types of cancer.
Observations Vaccines, such as those against human papillomavirus and hepatitis B, are composed of (1) an antigen target, (2) an adjuvant to activate the immune system, and (3) a vaccine delivery vehicle. Antigens can be derived from tumor mutations termed neoantigens, or cancer-associated nonmutated proteins, which are normal human proteins that are abnormally expressed in cancer. The tumor can also act as an antigen source, such as when immunization occurs with whole tumor cells or by directly injecting an immunogenic substance into the tumor to elicit an adaptive immune response. T and B lymphocytes, cells of the adaptive immune system, are stimulated by cancer vaccines and can provide a highly specific and durable immune response directed against cancer.


