The vaccine approach to cancer therapy is still in the early stages. Since any immune response has a limited capacity, immunotherapeutic manipulations to destroy tumor will probably be most effective against small tumor masses or micrometastases. Consequently, immunotherapy with these CEA cancer vaccines may prove most effective in the adjuvant setting, where disease has been controlled or stabilized with conventional therapies. The development of CEA cancer vaccines involves many parameters, including the appropriate form of the vaccine, i.e., recombinant protein, peptides, vectors etc., the use of classical adjuvants and/or biological adjuvants such as cytokines, and the use of T cell costimulatory molecules. The integration of these parameters into the development of a cancer vaccine will be the challenge for the next decade [33].