Prospects and challenges of neoantigen applications in oncology

•Overview of tumor-specific neoantigens as targets for personalized cancer therapies and their role in immune system recognition.•Discussion of clinical trials using neoantigens in cancer immunotherapy and the challenges posed by tumor heterogeneity and immune tolerance.•To explore advanced technologies for neoantigen identification and future strategies to improve their clinical application. Neoantigen, unique peptides resulting from tumor-specific mutations, represent a promising frontier in oncology for personalized cancer immunotherapy. Their unique features allow for the development of highly specific and effective cancer treatments, which can potentially overcome the limitations of conventional therapies. This paper explores the current prospects and challenges associated with the application of neoantigens in oncology. We examine the latest advances in neoantigen identification, vaccine development, and adoptive T cell therapy. Additionally, we discuss the obstacles related to neoantigen heterogeneity, immunogenicity prediction, and the tumor microenvironment. Through a comprehensive analysis of current research and clinical trials, this paper aims to provide a detailed overview of how neoantigens could revolutionize cancer treatment and the hurdles that must be overcome to realize their full potential.