Oncolytic viruses and neoantigen vaccines: opportunities and challenges in priming antitumour immunity

In the past years the therapeutic landscape in Oncology has been expanded, creating new possibilities in achieving superior tumor specificity and minimizing systemic toxicity. Amidst these, oncolytic viruses and cancer vaccines have risen as ingenious approaches that harness unique mechanisms of action, exploiting the immune system to destroy malignancies. Oncolytic viruses, typically modified to selectively infect cancer cells, ultimately lead to their destruction, offering both the benefit of direct cytolysis and the subsequent activation of our immune system, which might therefore improve durable responses. On the other hand, cancer vaccines, aim to provoke a targeted immune response against antigens that are tumor specific, ultimately enhancing immune surveillance and reducing the risk of relapse. Despite the promising rationale behind these approaches, there are significant challenges in areas such as the optimisation of therapeutic delivery, tackling tumor immune evasion and managing new emergent adverse events. This Series paper discusses the potential impact of these strategies on the current landscape of cancer treatment, while also covering the challenges that might emerge in clinical implementation.