Brain Tumor Vaccines: Next Steps.

High-grade gliomas remain among the most challenging malignancies despite extensive advances in molecular characterization and immunotherapy. This review highlights that while cancer vaccines consistently induce robust systemic immune responses, their clinical efficacy is limited by profound tumor heterogeneity and a highly immunosuppressive tumor microenvironment. Across peptide, dendritic cell, and mRNA-based platforms, outcomes are more strongly influenced by tumor biology than vaccine design. Emerging evidence supports a shift toward combinatorial strategies. Future progress will depend on spatially resolved tumor-immune analyses, biomarker-driven patient selection, and rational combination therapies to overcome immune resistance and achieve durable clinical benefit.