Breast cancer, a heterogeneous disease, is the frequently diagnosed cancer
and the leading cause of cancer-related deaths among women globally. Today, even if
the survival rate of breast cancer patients is increased with combination therapies
including chemotherapy, monoclonal antibodies, tyrosine kinase inhibitors or immune
checkpoint blockade in the patients resistant to the therapies, the disease progression
continues. Moreover, the clinical activity of the therapies is limited only to subsets of
patients. These difficulties highlight the necessitate for the development of alternative
treatment approaches. Vaccines that have protected humans against infectious diseases
for centuries are increasingly being developed due to the cost-effective approach
related to prevention, treatment, and eradication of cancer. In addition, vaccines confer
long-term immune memory critical to prevent tumor recurrence. Breast cancer vaccines
have been extensively tested in clinical trials, but no vaccine has been approved for
either breast cancer treatment or prevention yet. In the past years, tumor self-antigens
have been used in vaccine development. Tumor-specific antigens are not only present
in the tumor cell but also in normal cells. Such developed vaccines cause
immunological tolerance and cannot provide effective treatment. Currently,
neoantigens are popular during vaccine development against breast cancer.
Neoantigens formed by somatic mutations differ from self-tumor antigens and are
specific to each individual patient. Another important vaccine target is the cancer stem cell that plays a key role in tumor development, dissemination, and resistance to
therapy. Breast cancer vaccines targeting cancer stem cell and neoantigen can be used
either single or combined with chemotherapy and immune checkpoint blockade and are
also considered as an effective therapeutic strategy in breast cancer. In this chapter, the
vaccination strategies in current clinical trials and possible future directions for vaccine
development against breast cancer are portrayed and intensely discussed.
Keywords: Breast Cancer, Cancer Stem Cell, Dendritic Cell Vaccines, DNA
Vaccines, Immune Checkpoint Blockade, Neoantigen, Nucleic Acid Vaccines,
Peptide Vaccines, RNA Vaccines, Tumor Associated Antigen, Tumor Specific
Antigens, Viral Vector Vaccines, Whole Cell Vaccines.
