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3 Challenges and perspectives Generally, a tumor vaccine needs to go through these processes from bench to bedside, namely, establishment of antigenic targets (identification, immunogenicity evaluation, antigenic epitopes prediction, and production of tumor antigens), formulation structure design (selection of adjuvants, linkers, and delivery platforms), immunity evaluation ( in vitro and in vivo models to evaluate the immune responses of vaccines), and clinical application (design and implementation of clinical trials)

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The elevated B12 appears to be a consequence of disease activity, likely resulting from increased production of B12-binding proteins by tumor cells or from liver involvement in the cancer process

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