{
  "abstract": "Background Despite significant advances in early detection and therapeutic strategies, breast cancer (BC) continues to pose a major public health challenge. The treatment of HER2-positive (HER2 +) BC has evolved substantially over recent years with the advent of monoclonal antibodies (mAbs), small-molecule tyrosine kinase inhibitors (TKIs), and antibody–drug conjugates (ADCs). Clinical progress has been significantly accelerated by a deeper understanding of the immune-regulatory properties of this subtype and its interactions with the tumor microenvironment. Despite the availability of effective HER2-targeted therapies, approximately one-third of patients develops resistance, highlighting the need for novel and more durable treatment strategies. Indeed, while current treatments have shown promising efficacy by promoting a “passive immune response,” they are associated with the emergence of resistant clones. Conversely, vaccine-based therapies are designed to elicit a durable “active immune response” by presenting tumor-associated antigens that stimulate the host immune system to recognize and eliminate malignant cells. This approach has the potential to generate long-lasting immunological memory, preventing recurrence, disease progression, and the emergence of immune-evasive tumor variants. Main body This review provides a comprehensive overview of cancer vaccines strategies for HER2 + BC with emphasis on their mechanisms, advantages, limitations, and their current developmental status. We explore diverse delivery platforms, including peptide/protein-based, nucleic acid, and cell-based vaccines. The clinical utility of these strategies is assessed across different disease settings: from prevention and interception in pre-invasive lesions, to the (neo)adjuvant treatment of early-stage BC and the management of advanced metastatic disease. While advanced-stage BC often presents an immunosuppressive tumor microenvironment that hinders vaccine efficacy, early-stage disease offers a more favorable immunological milieu for inducing robust and durable T-cell responses. Furthermore, we discuss emerging innovations such as neoantigen discovery, next-generation adjuvants (e.g., TLR and STING agonists), and novel combinatorial approaches with checkpoint inhibitors to overcome immune evasion. Conclusion Although most BC vaccines remain under clinical investigation, they represent a promising frontier for achieving disease control and the coming decade is expected to yield pivotal insights into their clinical utility and therapeutic potential.",
  "abstract_shown": true,
  "affiliations": [
    "Oncology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II",
    "Clinical and Translational Oncology, Scuola Superiore Meridionale",
    "Medical Oncology, Breast & GYN Unit, IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori (IRST) “Dino Amadori”",
    "Department of Medicine (DMED), University of Udine",
    "U.O.C. Clinica Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Aldo Caltavituro"
    },
    {
      "affs": [
        1
      ],
      "name": "Claudia Martinelli"
    },
    {
      "affs": [
        2
      ],
      "name": "Michela Palleschi"
    },
    {
      "affs": [
        0
      ],
      "name": "Miriam Pirolo"
    },
    {
      "affs": [
        0
      ],
      "name": "Vincenza Cantile"
    },
    {
      "affs": [
        1
      ],
      "name": "Roberto Buonaiuto"
    },
    {
      "affs": [
        1
      ],
      "name": "Carmine De Angelis"
    },
    {
      "affs": [
        3
      ],
      "name": "Fabio Puglisi"
    },
    {
      "affs": [
        4
      ],
      "name": "Lucia Del Mastro"
    },
    {
      "affs": [
        0
      ],
      "name": "Grazia Arpino"
    },
    {
      "affs": [
        0
      ],
      "name": "Mario Giuliano"
    },
    {
      "affs": [
        1
      ],
      "name": "Michelino De Laurentiis"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fv95cqb4ydngs.bib",
  "cited_by": 0,
  "doi": "10.1186/s13046-026-03789-1",
  "fulltext_url": "https://doi.org/10.1186/s13046-026-03789-1",
  "id": "fv95cqb4ydngs",
  "issns": [
    "1756-9966"
  ],
  "landing_url": "https://doi.org/10.1186/s13046-026-03789-1",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "2403|Immunotherapy and Immune Responses"
    ]
  ],
  "openalex": "W7171264872",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/fv95cqb4ydngs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:46:36Z",
      "native_id": "ce63be3c6ca24e33ab1507870b5bba34",
      "source": "doaj",
      "url": "https://doi.org/10.1186/s13046-026-03789-1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2403|Immunotherapy and Immune Responses",
      "subfield": "immunology"
    }
  ],
  "title": "Unraveling the use of vaccine therapy in HER2-positive breast cancer: a comprehensive review of current state and future perspectives",
  "title_text": "Unraveling the use of vaccine therapy in HER2-positive breast cancer: a comprehensive review of current state and future perspectives",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:36Z",
  "url": "https://research.draconitic.com/paper/fv95cqb4ydngs",
  "venue": "Journal of Experimental & Clinical Cancer Research",
  "versions": []
}