Therapeutic cancer vaccines: Why so few randomised phase III studies reflect the initial optimism of phase II studies

► This review analyses why so many randomised therapeutic vaccine trials have failed to confirm the optimism of single centre phase 2 studies. ► Focussing on a few example vaccine trials reveals a number of different possible explanations. ► The success rate of future studies could be improved by excluding “inflammatory” phenotypes (by Biomarkers) as well as by combination with different modalities, such as radiotherapy and chemotherapy.