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The concept of anticancer vaccines is based on the fact that mutations in the cancer cell genome will lead to abnormal proteins and thus abnormal peptides presented on MHC-I molecules on cancer cells. When sensitised by vaccination the immune system might be able to recognise the altered epitopes and eradicate the tumours. The 2 main challenges for vaccine design are the choice of the antigen (e.g., dendritic cell-based approaches, peptides, whole attenuated tumour cells, RNA-based approaches) and the choice of the adjuvant required for the costimulatory signals to induce effective immune responses [25]. In addition, the strategies might differ for preventive approaches and the therapeutic setting. Cancer prevention by vaccine has become standard for virus-associated cancers, most prominently for cervical cancer caused by certain HPV (human papilloma virus) strains [26], but has also been discussed for high-risk populations for breast cancer and gastrointestinal malignancies [27, 28]. Therapeutic peptide cancer vaccines have been tested for minimal residual disease in prostate cancer [29] and in advanced renal cell carcinoma [30]. Sipuleucel-T, a dendritic cell-based vaccine has been FDA approved in castration-resistant prostate cancer [31, 32].