Journal of Vaccine Research 2024, Vol.14, No.5, 255-268 http://medscipublisher.com/index.php/jvr 259 Figure 1 Association of magnitude and duration of vaccine-associated ERBB2 ICD T-Cell immunity with Dose (Adopted from Disis et al., 2022) 4.3 Recurrence prevention Preventing cancer recurrence is a primary goal of cancer vaccines. Several studies have demonstrated the potential of these vaccines in reducing the risk of breast cancer recurrence. For instance, a phase II study of HER2 vaccines (WOKVAC and DC1) in patients with residual invasive disease after neoadjuvant therapy showed promising results in terms of recurrence-free survival. The study found that both vaccines were well-tolerated and induced significant immune responses, which correlated with a reduced risk of recurrence (Han et al., 2023). Another study on the E75 vaccine, which targets the HER2/neu protein, reported a lower recurrence rate in vaccinated patients compared to controls. Although the difference in recurrence rates lost significance over time, the pattern of recurrence remained significantly different, suggesting a potential long-term benefit of the vaccine in preventing recurrence (Peoples et al., 2008). These studies underscore the importance of cancer vaccines in providing long-term protection against breast cancer recurrence, thereby improving patient outcomes. In conclusion, cancer vaccines have shown significant promise in inducing long-term immunological effects, including persistent T-cell responses, durable antibody-mediated immunity, and reduced recurrence rates. Continued research and optimization of these vaccines are essential to fully harness their potential in the fight against breast cancer. 5 Case Study: HER2/neu Vaccine in Breast Cancer Patients 5.1 HER2-targeted vaccines HER2-targeted vaccines have emerged as a promising therapeutic strategy for breast cancer patients, particularly those with HER2/neu overexpression. These vaccines aim to stimulate the immune system to recognize and attack HER2-positive cancer cells. Various approaches have been explored, including peptide-based vaccines, plasmid DNA vaccines, and whole-cell vaccines. Peptide-based vaccines, such as those targeting the HER2 intracellular domain, have shown potential in clinical trials. For instance, a Phase I/II trial demonstrated that HER2-specific T-cells could be expanded ex vivo after in vivo priming with a multiple peptide-based HER2 vaccine, leading to significant T-cell responses and epitope spreading in patients (Disis et al., 2023). Another study reported the safety and immunogenicity of a HER2 plasmid DNA vaccine administered with low doses of GM-CSF and IL-2, which induced long-lasting HER2-specific antibodies and T-cell responses in metastatic breast cancer patients . Whole-cell vaccines, which use genetically modified cells to express HER2 and other immunostimulatory molecules, have also been investigated. These vaccines aim to provide broad antigenic coverage and stimulate robust immune responses. For example, a tri-antigen vaccine targeting HER2, IGFBP-2, and IGF-IR was shown to
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