In this paper, a Caputo fractional tumor immune model of combination therapy is established. First, the stability and biological significance of each equilibrium point are analyzed, and it is demonstrated that chaos may arise under specific conditions. Combined with the mathematical definition of Caputo fractional differentiation (CFD), it is found that there is a high correlation between the chaotic phenomenon of the patient's condition and the sensitivity of the patient to the change in the state of the day. The bifurcation threshold of each parameter is determined through numerical simulation, and the Hopf bifurcation of direct competition coefficient and inhibition coefficient between tumor cells and host healthy cells is elaborated upon in detail. Subsequently, a novel method combining optimal control theory with the particle swarm optimization (PSO) algorithm is proposed for the optimal control of the tumor immune model in combination therapy. Finally, the Adams-Bashforth-Moulton (ABM) prediction correction method is utilized in numerical simulations which demonstrate that the introduction of the CFD alters the model dynamics. Furthermore, these results indicate that fractional calculus can effectively be applied to tumor immune models better to elucidate complex chaotic dynamics of tumor cell evolution. Concurrently, the PSO can be successfully integrated with optimal control theory to address optimization challenges in cancer treatment.