title: Active immunotherapy in HER2 overexpressing breast cancer: current status and future perspectives.
abstract: BACKGROUND
  The use of anti-HER2 monoclonal antibodies (mAbs) has improved the clinical outcome of HER2-overexpressing breast cancers (BCs). Unfortunately, often these tumors tend to relapse and, when metastatic, the duration of clinical benefit is limited over time and almost invariably followed by tumor progression. Alternative approaches to this essentially passive immunotherapy are therefore needed in HER2-overexpressing BC patients. As HER2 is one of the most suitable targets for active immunotherapy in BC, manipulating the immune system is a highly attractive approach.
  
  
  METHODS
  A computer-based literature search was carried out using PubMed (keywords: breast neoplasm, HER2 vaccine, immunology); data reported at international meetings were included.
  
  
  RESULTS
  This review provides a focus on the following active vaccinal approaches under clinical investigation against HER2-overexpressing BC: (i) peptide and protein based; (ii) DNA based; (iii) whole tumor cell based; (iv) dendritic cell based. Moreover, the review discuss future challenges in the field, trying to define the best setting for the development of this innovative strategy, considering both immunological and clinical aspects of HER2 targeting.
  
  
  CONCLUSIONS
  Development of effective vaccines for BC remains a distinct challenge but is likely to become a substantial advance for patients with HER2-overexpressing BCs.
authors.affiliation: Medical Oncology I, Institute for Cancer Research and Treatment (IRCC) Candiolo FPO (Fondazione del Piemonte per l'Oncologia); Department of Oncology, University of Torino Medical School, Candiolo.
authors.forename: A
authors.initials: A
authors.lastname: Milani
authors.affiliation: Medical Oncology I, Institute for Cancer Research and Treatment (IRCC) Candiolo FPO (Fondazione del Piemonte per l'Oncologia); Department of Oncology, University of Torino Medical School, Candiolo.
authors.forename: D
authors.initials: D
authors.lastname: Sangiolo
authors.affiliation: Medical Oncology I, Institute for Cancer Research and Treatment (IRCC) Candiolo FPO (Fondazione del Piemonte per l'Oncologia); Investigative Clinical Oncology Unit (INCO), Candiolo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Montemurro
authors.affiliation: Medical Oncology I, Institute for Cancer Research and Treatment (IRCC) Candiolo FPO (Fondazione del Piemonte per l'Oncologia); Department of Oncology, University of Torino Medical School, Candiolo.
authors.forename: M
authors.initials: M
authors.lastname: Aglietta
authors.affiliation: Medical Oncology I, Institute for Cancer Research and Treatment (IRCC) Candiolo FPO (Fondazione del Piemonte per l'Oncologia); Department of Oncology, University of Torino Medical School, Candiolo. Electronic address: giorgio.valabrega@ircc.it.
authors.forename: G
authors.initials: G
authors.lastname: Valabrega
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000938:Antigen-Presenting Cells / Q000276:immunology / Q000637:transplantation; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D019496:Cancer Vaccines; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016233:Immunotherapy, Active; D000077341:Lapatinib; D011799:Quinazolines / Q000627:therapeutic use; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000276:immunology / Q000378:metabolism*; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D000077341:Lapatinib; D011799:Quinazolines; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: HER2; active immunotherapy; breast cancer; vaccine