High risk and metastatic
breast cancer remain a major therapeutic challenge. Although the role of high dose
chemotherapy followed by
stem cell transplantation (SCT) in the overall treatment strategy is not yet well defined, it is clear that new forms of
therapy such as
immunotherapy will be needed to cure the majority of patients with advanced disease. We review important considerations for
immunotherapy in the post-
transplantation period. Experimental and clinical data suggest that
immunotherapy may be most effective in a state of
minimal residual disease such as that achieved following SCT. However, high dose
therapy and autologous SCT result in an iatrogenic immune deficiency, which compounds the suppression of the immune system associated with
tumor itself. Understanding reconstitution of a functional immune system post
transplantation is critical in devising clinically effective immune interventions. A review of the clinical studies of post transplant
immunotherapy for
breast cancer is presented including autologous and allogeneic strategies, as well as perspectives for future development.