The tumour microenvironment diversity among patients poses a challenge for conventional therapies, leading to limited efficacy. Furthermore, conventional methods are inherently associated with a negative impact on healthy tissues. Personalized immunotherapy, focused on individual tumor characteristics, has emerged as a potential solution. Neoantigens, unique antigens arising from tumour-specific mutations, play a crucial role in personalized therapy. Identifying and utilizing neoantigens through therapeutic vaccines can induce an immune response specifically against tumour cells, offering a more targeted and less toxic for healthy tissues approach to cancer treatment. The vaccines can potentially lead to tumour regression and improved outcomes. The effectiveness of this therapy is still limited due to phenomena such as immune escape. However, ongoing scientific research, technological advancements, and emerging combination therapies offer hope for the success of neoantigen-based therapeutic cancer vaccines, ushering in a new era in personalized oncology.