A Phase I/II safety and immunogenicity evaluation trial of trastuzumab combined with ERBB2 vaccination in patients with metastatic breast cancer has recently been published.

Twenty-two patients with stage IV, ERBB2-positive breast cancer who were being treated with trastuzumab were vaccinated with an ERBB2 peptide-based vaccine that stimulates CD4+ T helper cells. These cells should enter the tumour and, through interactions with antigen-presenting cells, enable the activation of cytotoxic T cells that bind ERBB2 and other tumour antigens. Monthly vaccinations were administered intradermally for the first 6 months of the trial. The response of T cells to the vaccine was monitored using interferon-γ-linked immunosorbent spot assay. Although most patients had pre-existing T cell responses to ERBB2 and other breast cancer antigens, these were boosted and prolonged by the vaccine. Epitope spreading in the form of response to additional tumour-related antigens was also evident.

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