<p>Therapeutic vaccines for cancer have been pursued for decades but historically have a low rate of clinical efficacy. However, recent advances in vaccine technologies alongside new vaccination regimens and clinical trial designs are showing promise in early-stage trials, demonstrating substantial benefits in recurrence-free and overall survival in cancer patients. Nanotechnologies are playing an important role in these advances through the introduction of lipid nanoparticles and lipoplexes that can effectively deliver mRNA vaccines, improved adjuvants, and the development of technologies that efficiently target peptide vaccines to secondary lymphoid tissues. Here we review these advances in the context of parallel progress in cancer antigen discovery, nucleic acid vaccine engineering and clinical trial designs that may enable therapeutic vaccines to effectively enhance patient survival. We also discuss outstanding challenges still to be solved to maximize the efficacy of cancer vaccines.</p>