Dendritic Cell Therapy for Breast Cancer in Germany

Breast cancer is one of the most common cancers in the world. In 2020, doctors recorded about 2.3 million new cases of breast cancer in women and around 685,000 deaths worldwide.^[1] Even though treatments have improved a lot over the last few decades, many people are still at risk of the cancer returning or spreading.

Doctors and researchers are exploring new options that do more than simply shrink tumours. One of the most interesting areas is dendritic cell therapy. Germany is among the countries where this approach is being developed and offered in specialised centres with exceptional results. We give special attention to the dendritic cell therapy stage 4 cancer aspect, as one of the most searched solutions for certain patients.

Tell us about your case

Overview of Dendritic Cell Treatment in Breast Cancer

Many patients do well with standard treatments, but a significant number still face the risk of relapse or metastatic disease.^[2] Dendritic cell treatment, so-called DCT, is a newer form of immunotherapy that began to be used in practice in Germany in the late 1990s/early 2000s.^[3] To understand what this approach can and cannot offer, it is important to first see how dendritic cell therapy for breast cancer works and which malignant subtypes may be suitable.

Basic Principles

Dendritic cells are rare immune cells, but they play a key role in directing immune responses. Their main job is to act as “messengers” between dangerous targets and the T cells that carry out precise attacks.^[4]

When they encounter something abnormal, such as a cancer cell, they take up small pieces of it called antigens. Then they travel to the lymph nodes, where many T cells are waiting, and “show” these antigens on their surface so T cells learn precisely what to hunt down.^[5] Because of their role, dendritic cells are considered the most effective antigen-presenting cells.

To explore the dendritic cell working mechanism in depth and have a more detailed understanding of general key aspects, read our dedicated dendritic cell cancer treatment guide.

How Dendritic Cell Vaccines Target Breast Cancer Cells

First, doctors collect white blood cells, sometimes using a procedure called leukapheresis, which can harvest large numbers of immune cells from circulating blood.^[6] These cells are cultured in the laboratory with specific growth factors to develop into dendritic cells.^[7] At this point, the team adds breast cancer antigens. These antigens can come directly from the patient’s tumour tissue or from defined proteins, such as HER2, which is overexpressed in a significant proportion of breast cancers.^[8]

Once the dendritic cells have taken up these antigens and matured, they are used to make a vaccine. When the solution is re-administered to the patient, dendritic cells migrate and present tumour antigens to T cells. This can activate “killer” T cells, which can destroy tumour cells that carry the same antigens, and “helper” T cells, which support other parts of the immune system.^[9] Over time, these activated T cells spread through the body. If they encounter breast cancer cells that display the target antigens, they are more likely to recognise and attack them. The aim is to activate the natural immune system recognition and response.

Request an expert consultation

Eligible Breast Cancer Types

Dendritic cell therapy in Germany is usually available through clinical trials or specialised immunotherapy clinics and is almost always used in combination with established treatments.^[10] At this point, this treatment is not a standard part of breast cancer care guidelines.^[14]

There is no particular subtype of breast tumors that is not fit for the treatment. The indication is not based on the molecular profiling. We show here that even resistant breast cancer disease can be exposed to the DC vaccine.

HER2-Positive Variant

Doctors are mainly focusing on certain subtypes where they expect the most potent immune effects. One such group is HER2-positive breast cancer.^[10] These tumours have a clear target, the HER2 protein, which can be used as the primary antigen for the vaccine.^[11] Trials with HER2-directed dendritic cell vaccines have shown meaningful rates of pathologic complete response when the vaccine is given before surgery, along with standard HER2-targeted drugs and chemotherapy.^[12][13]

Triple-negative Breast Cancer

Another important group is triple-negative breast cancer (TNBC). This subtype lacks estrogen receptors, progesterone receptors, and HER2. TNBC is often more aggressive and has fewer targeted treatment options, which is why immunotherapy, including dendritic cell vaccines, is actively studied here.^[15] In some trials, dendritic cell vaccination has been combined with chemotherapy before surgery, and in others, it is being tested together with modern checkpoint inhibitor drugs.^[17]

Hormone Receptor-Negative Disease

Dendritic cell therapy is also explored in HER2-negative and hormone-negative tumours outside the classic triple-negative group.^[16] In these settings, the vaccine may be based on a mixture of different tumour antigens rather than a single marker.^[17]

Speak with a consultant

Why Consider Germany?

Germany has built a reputation as one of the world’s strongest medical systems, which is especially important if you are looking for a breast cancer vaccine Germany option, such as dendritic cell therapy.^[18] It is a personalised, lab-intensive product that needs strict quality control, specialised immunology teams, and clear safety rules. Germany combines all of these: a strong regulatory authority, a large cancer research community, and a dense network of hospitals and certified clinics that work with international patients every day.

Regulatory Standards & Licensing for Dendritic Cell Products

Dendritic cell vaccines belong to a group of medicines called advanced therapy medicinal products and cell-based immunotherapies.^[19] In Germany, the regulation is shared between the European Medicines Agency (EMA) and the national authority, the Paul-Ehrlich-Institut (PEI).^[20] The PEI is the federal institute for vaccines and biomedicines and acts under the German Federal Ministry of Health. It is responsible for the approval and monitoring of clinical trials with therapeutic vaccines and many cell-based products in Germany.

On the European level, there are specific guidelines for human cell-based products and for potency testing of cell-based immunotherapies. These guidelines describe how manufacturers must prove identity, purity, potency, and safety before a product can be tested in humans or used in routine care. Germany closely applies these rules, so any dendritic cell product must meet both EU requirements and national regulations before it can be produced and used.

A key concept is Good Manufacturing Practice (GMP). DC vaccines in Germany are and must be produced in GMP-certified clean rooms, where air quality, equipment, staff training, and documentation are strictly controlled.^[21] German institutes and contract manufacturers have invested heavily in such facilities. For example, the Fraunhofer IZI institute in Leipzig received official German certification to manufacture a commercial dendritic cell vaccine (DCVax-L) from Northwest Biotherapeutics for an international company, demonstrating that its processes met national and EU standards.^[22]

For patients, this means that a dendritic cell therapy for breast cancer in Germany is not just a lab service as in many other countries. It is treated as a medicinal product, with obligations for licensing, pharmacovigilance, batch release, and regular inspections.^[23] Clinics and laboratories must hold specific permissions under German drug law to prepare and administer autologous cell products. This framework does not guarantee success in every individual case, but it does create a clear safety net and reduces the risk of uncontrolled or poorly documented treatments.

Research & Trials for Breast Cancer

Dendritic cell vaccination is among the most widely studied forms of cancer immunotherapy worldwide. The field includes more than 200 clinical trials of DC vaccines across different cancers, from early-phase I safety studies to phase II and III trials.^[24] Market analyses list over 50 dendritic cell cancer vaccines in the global development pipeline, along with a small number of licensed DC-based products already on the market.^[25] Germany is involved in this development both as a research hub and as a host country for many of these trials.

The German Cancer Research Center (Deutsches Krebsforschungszentrum) in Heidelberg is the largest biomedical research institution in Germany, with more than 3,300 employees focusing on immuno-oncology and vaccine development. Research groups there and at partner university hospitals work on dendritic cell biology, oncological vaccines, and combinations with checkpoint inhibitors or other immunotherapies.^[26]

In recent years, German clinics and research institutes have been active contributors at major immunotherapy meetings such as CIMT in Mainz, which specifically highlight therapeutic vaccines and cell-based immunotherapy.^[27]

German Provider Network

Patients who come searching for dendritic cell therapy for breast cancer in Germany do not find a single “central clinic,” but a network of providers. This network includes large university hospitals, national research centres, and smaller specialised immunotherapy clinics.

On the public side, university hospitals affiliated with centres like DKFZ are part of the German network of certified cancer centres and are deeply involved in clinical research.^[28] These hospitals are used to running complex trials, often more than 100 clinical studies per year across all cancer types, and many now include immunotherapy and cell-based approaches such as dendritic cell vaccines.^[29] Alongside the academic system, there are private clinics and cancer centres that focus on personalised immunotherapy and medical tourism for cancer care.

For a patient, this means Germany offers breadth and depth: a vast network of hospitals and clinics familiar with dendritic cell therapies for international patients. But it also means that choosing the right centre is crucial. Airomedical has a relevant ranking highlighting top specialized immunotherapy clinics in Germany, some of which are highly focused on DC-like treatments.

Request a second opinion

Who Is a Candidate for Dendritic Cell Therapy in Germany?

Not every person with breast cancer is a good candidate for DC immunotherapy for breast cancer in Germany. Therefore, select patients carefully, considering tumour stage, biology, prior therapies, and general health before the administration, whether within a study or at a specialised immunotherapy clinic.

Early-Stage Breast Cancer

A large share of breast cancers are found at an early stage, when the tumour is still confined to the breast or nearby lymph nodes.^[30] This early window is also where many researchers see the best chance for immunotherapy, because the immune system is usually stronger and the total tumour burden is lower.

In practice, early-stage means stage I-III disease. German and international trials with DC vaccines often recruit women who have a clearly defined tumour in the breast, sometimes with positive lymph nodes, but without distant metastases. One extensive study in HER2-negative early breast cancer, which included 83 patients, tested the addition of dendritic cell vaccination to standard neoadjuvant chemotherapy before surgery.^[31] Other studies and ongoing programmes focus on HER2-positive early breast cancer, where the vaccine is directed against HER2 and given alongside drugs like trastuzumab in stages I–III.^[13]

As a result, typical early-stage candidates in Germany are patients who already qualify for intensive treatment at a comprehensive cancer centre. This immunotherapy type is usually considered for fit patients with a higher risk profile, and almost always as an extra layer on top of surgery, chemotherapy, and targeted drugs rather than a stand-alone replacement.^[16]

Metastatic Stage 4 Breast Cancer

Stage 4, or metastatic, breast cancer means that the tumour has spread beyond the breast and regional lymph nodes to distant organs such as bone, liver, lung, or brain.^[32] The limited standard treatment effectiveness in advanced breast disease explains why many patients and doctors seek additional options as standard treatments begin to lose efficacy.

In Germany, several immunotherapy centres openly describe stage IV or metastatic disease as a key dendritic cell therapy for breast cancer indication, mainly when previous lines of treatment have failed or produced only partial control.^[33][34] Women with triple-negative disease, metastatic spread, or tumours that no longer respond to chemotherapy and targeted drugs are among the most common candidates. For these patients, realistic goals are slowing tumour growth, reducing symptoms, and possibly extending survival while keeping side effects low.

DC vaccines are widely used for patients with metastatic stage 4 breast cancer, but require good performance status and stable organ function, because patients need enough time and reserve to undergo leukapheresis, lab processing, and repeated vaccinations.

Dendritic cell therapy in Germany is an everyday practice. Therefore, a typical stage 4 candidate is someone who has already received several standard treatments. Still has a reasonable general condition, and is motivated to try an experimental but biologically rational option. Patients with very fast-growing disease, severe organ failure, or a life expectancy of only a few weeks are much less likely to benefit. At the same time, it's reasonable to check each dendritic cell therapy stage 4 cancer case individually with the selected clinic.

Medical Contraindications & Limitations

Even when the tumour type and stage look suitable, certain medical conditions can make dendritic cell therapy for breast cancer unsafe or unrealistic. As a rule, German centres follow eligibility criteria similar to those used in advanced therapy clinical trials. These usually demand stable heart, liver, and kidney function, no uncontrolled infections, and a performance status that allows the patient to attend repeated clinic visits over several months.^[35]

Serious or poorly controlled autoimmune diseases are a frequent concern. Many clinics don't accept patients with active autoimmune disorders, or take them only when the disease is mild and well controlled on low-dose medication, because intense stimulation of the immune system might trigger flares.^[36] Similarly, patients with advanced heart failure, recent heart attacks, or severe lung disease may not pass the safety checks that German immunotherapy centres apply before offering any cell-based treatment.^[35]

Finally, there is the fundamental limitation that dendritic cell therapy for breast cancer is still experimental. Regulatory agencies in Europe recognise DC vaccines as promising, but they have not yet approved a standard, widely available product specifically for breast cancer. That means access is mostly through trials or specialised centres, and decisions are made on a case-by-case basis.

Ask the oncologist

Procedure Details in German Centres

In German centres, the basic steps of the therapy follow the same international standard used for many cancer types, not only breast cancer. The process is well described in our general DC guide.

The treatment process consists of the follwing steps:

1. First, your immune cells are collected by leukapheresis;
2. Then they are turned into dendritic cells;
3. The DCs are "trained" with tumour information in the lab;
4. Finally, they are returned to you as a personalised vaccine via intradermal injection.

What can be Different in Germany?

Some German clinics use a more straightforward approach for the cells collection: they collect about 200 ml of blood instead of a full leukapheresis and send the sample straight to their clean-room laboratory the same day.

Real-world schedules often include 2 to 8 doses, with the first injections given every one to three weeks and later doses spaced further apart.^[37] Many German hospitals practice an individual approach in vaccine numbers and scheduling, adapting to the patient's needs rather than the standard flow.

Another German feature is the use of a DCT as part of combination therapy. The integrative oncology approach might include DC therapy, chemotherapy with hyperthermia, or another palliative care alternative under one roof.

German Data for Efficacy & Prognosis

We have prepared a cumulative table showing the actual, data-driven dendritic cell therapy success rate in Germany. It helps patients understand the confirmed effectiveness and align their expectations with real results.

Clinical Experience With Dendritic Cell Vaccines in Breast Cancer

Study / Publication	Time	Place	Study Details*	Outcomes
Schuetz et al., “Treatment of advanced metastasized breast cancer with bone marrow-derived tumour-reactive memory T cells: a pilot clinical study.”[38]	2009	University Hospital Heidelberg	12 women having dendritic cell therapy stage 4 cancer treatment. Bone marrow T cells were obtained from each patient and reactivated in the lab using an autologous vaccine with breast cancer cell lysate (MCF-7). The activated T cells were then given back as a single transfusion. Primary goal: feasibility and immune activation.	Treatment was feasible and well tolerated in 100% (12/12) of patients. After one infusion, 6 of 12 women (50%) developed new tumour-specific, IFN-γ–producing T cells in the blood (“immunologic responders”), while the other 6/12 (50%) showed an IL-4–dominant, non-favourable immune pattern.
Domschke et al., “Long-term survival after adoptive bone marrow T cell therapy of advanced metastasized breast cancer.”[39]	2013	University Hospital Heidelberg	Follow-up of the Heidelberg program, now 16 metastatic breast cancer patients, including the original 12. Again, bone marrow memory T cells were reactivated with autologous dendritic cells loaded with MCF-7 lysate, then reinfused as a single “adoptive T-cell” infusion. Here, the team focused on long-term survival and its link to immune response.	After treatment, 7 of 16 patients (44%) showed a clear tumour-specific T-cell response in blood and were classed as “immunologic responders”; 9/16 (56%) were non-responders. Overall median survival for the whole group was 33.8 months. Three women (about 19% = 3/16) were still alive more than 7 years after therapy. Responders lived much longer: median 58.6 months vs 13.6 months in non-responders (p = 0.009). In other words, patients whose T cells were successfully driven into a type-1, tumour-fighting pattern had a median survival about 4 times longer than those without such an immune response.
Schirrmacher & Stücker et al., “Long-term survival of a breast cancer patient with extensive liver metastases upon immune and virotherapy: a case report.”[40]	2015	Immun-Oncological Center Cologne	A 70-year-old woman with invasive ductal breast cancer and extensive liver metastases. She refused further standard systemic therapy after surgery. At IOZK, she received an individualized multimodal program combining local hyperthermia, oncolytic Newcastle disease virus, and autologous dendritic-cell vaccination prepared from her own blood cells and tumour antigens.	For this one patient, the outcome was remarkable compared with usual expectations for liver-metastatic breast cancer: she reported a continuously good quality of life. She survived more than 66 months (5.5+ years) after the initial diagnosis, with no further metastases or relapse reported during follow-up. Immune testing showed long-lasting tumour-reactive memory T-cell responses after the DC-based program. Because this is just 1/1 patient, the apparent “100% success” cannot be generalized, but it illustrates what DC-centred multimodal therapy can sometimes achieve in highly selected cases.
Nesselhut et al., “Dendritic cell–based immunotherapy in a patient with hematogenous metastatic breast cancer.”[41]	2004	Practice Group for Cell Therapy Duderstadt	Single-patient case report. A woman with widespread metastases (liver, skeleton, pleura, and peritoneum) after conventional therapies. Treated with repeated autologous DC vaccinations, generated from her monocytes and loaded with tumour antigens.	Reported clinical complete remission of measurable disease after DC-based therapy, with a progression-free interval of 9 months following remission. For that individual patient, this corresponds to a 100% objective response and 9-month PFS, in a setting where expected median PFS with best supportive care is often only a few months.
Nesselhut et al., “Cancer therapy with immature monocyte-derived dendritic cells in patients with advanced breast cancer.”[42]	2005	University Hospital Göttingen + Practice Group for Cell Therapy Duderstadt	Prospective series of 143 women with advanced/metastatic breast cancer. Monocytes were collected from peripheral blood, cultured with GM-CSF + IL-4 to generate immature monocyte-derived DCs (iMoDC), then loaded with tumour cell lysate, known tumour peptides, or tumour proteins from autologous serum. The therapy was given intradermally or intravenously, usually as repeated vaccinations in patients who had exhausted standard options.	Clinical response in 37% (56/143): 7 complete remissions (~4.9%), 14 partial remissions (~9.8%), 33 stable disease (~23.1%), 3 mixed responses (~2.1%). Median overall survival from start of DC therapy was 25 months (range 2–59) in responders vs 4 months (1–39) in non-responders. 3-year overall survival 16% vs 1% (responders vs non-responders).

*The data are gathered only concerning breast cancer treatment with DCT.

Studies from University Hospital Heidelberg

Case Report from Immun-Oncological Center Cologne

Nesselhut Case Report from Practice Group for Cell Therapy Duderstadt

Study from University Hospital Gottingen & Practice Group for Cell Therapy Duderstadt

Understanding Effectiveness Data

Among the most asked and direct questions all patients are curious about: “What is the effectiveness and what do the real results look like?” Here, we summarized the German results (mentioned in the table above) and the breast cancer dendritic cell therapy success rate in plain language.

• What is the general response rate in Germany? In the German data we have, about 4 out of 10 (40%) patients showed a positive effect from DC-based treatment. In single-patient case reports, it is 1 out of 1 (100%), but those are exceptional cases and not the average.
• How long can you live compared to standard care? In these German reports, patients who responded often lived 2 to 4 times longer after DC-based treatment than those who did not respond. But these are small, selected groups and do not guarantee the same result for everyone.
• Is the German success rate higher than the worldwide data? German results look good and sit at the upper end of this range, but not clearly better than what is seen in other countries with similar small studies.
• Is German research experience the most extensive? Germany has some important centres and has been active for a long time. DC therapy has been used in Germany for breast cancer for more than 20 years (since the early 2000s). The country is one of several experienced destinations in DC therapy, but it is not the only leader in breast cancer research.
• Is it safe to have a dendritic cell therapy in Germany? In these German studies, treatment was generally well tolerated. Most side effects were mild (flu-like feeling, tiredness, local redness). Severe problems were rare in the published data.

Get consultation

Dendritic Cell Therapy Cost in Germany

The price of dendritic cell therapy in Germany is highly variable, as it is a personalised immunotherapy, lab-made treatment often combined with other cancer therapies. Still, it is possible to describe a typical range that many patients can expect.

Typical Price Range

For most patients, a complete dendritic cell program in Germany, including cell collection, lab processing, and vaccine injections, has different costs depending on case details and which clinic is providing it. In simple terms, dendritic cell therapy costs often range from €19,000–€25,000 for a small (standard) program to €50,000 or more for longer courses with several treatment cycles. The quote mentioned does not include travel, hotel, or everyday costs.

What Is Included in The Program

A typical dendritic cell (DC) program in Germany is more than just a few injections. It usually includes an in-depth medical review of your breast cancer history, blood tests, and scans, as well as leukopheresis and a blood sample to collect immune cells from your blood.

It also covers the laboratory work to turn these cells into dendritic cells and “load” them with information from your tumour. The ready vaccine is then returned to you and is also included in the typical cost of a dendritic cell therapy.

Many centres also include regular follow-up visits with imaging and blood tests, so doctors can see both how your cancer behaves and how strongly your immune system is reacting.

Factors That Influence the Total Cost

The total cost of a dendritic cell program in Germany can vary a lot from patient to patient. It first depends on how many vaccine cycles you receive for your breast cancer case, which clinic and doctor will be involved, and over what period.

The price is also strongly influenced by the type of cell collection (a simple blood draw is cheaper than leukapheresis), the use of a GMP-certified clean-room lab, and whether you also need chemotherapy, hormone therapy, or targeted drugs in the same clinic.

On top of the medical bill, international patients have to add travel, accommodation, and translator or support services, especially if they need to stay in Germany for several weeks.

Get personal cost

Best Dendritic Cell Therapy Hospitals in Germany

Several centres, both university hospitals and specialised clinics, offer DCT under different programs. Instead of one single “best” hospital, patients should look for clinics that are licensed, work with certified laboratories, and have real experience in immunotherapy and breast cancer, especially for their specific tumour type.

University & Academic Cancer Centers

Several large university hospitals offer dendritic-cell–based immunotherapy for breast cancer in Germany primarily within research and clinical trial programs, not as standard of care.

At University Hospital Heidelberg, dendritic cell work is closely linked to the National Center for Tumor Diseases and the University Women’s Hospital. Breast cancer immunotherapy studies have been led by teams around Prof. Florian Schütz and Dr. Carmen Domschke, who have used dendritic cell therapy stage 4 cancer approach to activate the patient’s own T cells and have published some of the longest survival data.^[43]

At University Hospital Rechts der Isar in Munich (TUM), dendritic cell therapy for breast cancer sits inside an extreme translational research environment: the hospital is part of the Comprehensive Cancer Center Munich TUM and works closely with TranslaTUM, a large centre where doctors, immunologists, engineers, and biologists develop new cancer immunotherapies together, including projects on dendritic cells and tumour-immune interactions.^[44] This tight link between the cancer ward and a modern research campus is a key distinguishing feature of TUM compared with many other dendritic cell therapy hospitals.

In the University Hospital Charité Berlin, dendritic-cell–related work is anchored in the Charité Comprehensive Cancer Center (CCCC) and the departments of haematology, oncology, and tumour immunology.^[45] Research groups there have contributed to vaccine and cell-therapy trials in several solid tumours, and earlier German work on gene-modified dendritic cell vaccines for pancreatic and breast cancer patients is linked to investigators in Berlin, such as Prof. Giselher Pecher, whose group developed one of the first DC vaccines tested in these diseases.

Specialized Immuno-Oncology Clinics

University facilities can have restricted indications, high administrative costs, and may not be available to some patients. Therefore, it's reasonable to check where I can get dendritic cell therapy among private clinics.

The Practice Group for Cell Therapy Duderstadt is often seen as a key private destination offering dendritic cell therapy for breast cancer. The team around Dr. Thomas Neßelhut has worked with cell-based immunotherapy for decades and helped develop one of the first active specific immunotherapies (ASI) for ovarian cancer back in the 1980s at the University Women’s Clinic Göttingen. Today, the clinic runs its own GMP-compliant clean-room lab, holds a manufacturing licence for somatic cell therapeutics, and focuses on dendritic cell–based vaccines for advanced breast and gynaecological cancers, among others. It is also listed among the selected German centres specialising in immunotherapy, which is why many international patients look at it first when they search for DC options.

The Immuno-Oncological Center Cologne (IOZK) offers an individualised program built around its own tumour vaccine IO-VAC. This treatment combines the patient’s dendritic cells, tumour antigens, and the oncolytic Newcastle disease virus. IOZK has its own high-grade laboratories. The program is led by an experienced team, including Dr. Wilfried Stücker and colleagues, and typically combines DC vaccination with virotherapy and hyperthermia in a single concept.

The Hallwang Private Oncology Clinic in the Black Forest is another well-known integrative cancer centre. It is widely promoted for personalised immunotherapies in stage 4 breast cancer, including checkpoint inhibitors, targeted drugs, and, in selected cases, dendritic cell vaccines as part of larger treatment plans.

LDG – Laboratories led by Dr. Frank Gansauge offering dendritic cell therapy in Ulm, Germany. The clinic focuses almost entirely on dendritic cell therapy under the brand name LANEX-DC. LDG prepares vaccines in a GMP-certified clean room and mainly treats solid tumours, including breast and ovarian cancers.

Finally, the Centre of Advanced Medicine in Frankfurt am Main offers dendritic cell therapy as part of a broader program of “advanced” or biological cancer approaches. According to the clinic, DC therapy here is usually delivered as an outpatient treatment, during which patients can also receive supportive methods such as hyperthermia or infusions.

Choose a clinic

FAQ

References

1. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021, May). Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 71(3), 209–249. https://doi.org/10.3322/caac.21660. Retrieved December 2025.
2. Rubio, M. (2025). What to know about breast cancer recurrence. Breast Cancer Research Foundation. Retrieved December 2025.
3. Linette, G. P., & Carreno, B. M. (2022, March 15). On the twentieth anniversary of dendritic cell vaccines – Riding the next wave. Cancer Research, 82(6), 966–968. https://doi.org/10.1158/0008-5472.CAN-21-4440. Retrieved November 2025.
4. Caffiyar, M. Y., Lim, K. P., Basha, I. H. K., Hamid, N. H., Cheong, S. C., & Ho, E. T. W. (2020, May 19). Label-free, high-throughput assay of human dendritic cells from whole-blood samples with microfluidic inertial separation suitable for resource-limited manufacturing. Micromachines, 11(5), 514. https://doi.org/10.3390/mi11050514. Retrieved November 2025.
5. Liechtenstein, T., Perez-Janices, N., Bricogne, C., Lanna, A., Dufait, I., Goyvaerts, C., Laranga, R., Padella, A., Arce, F., Baratchian, M., Ramirez, N., Lopez, N., Kochan, G., Blanco-Luquin, I., Guerrero-Setas, D., Breckpot, K., & Escors, D. (2013, September). Immune modulation by genetic modification of dendritic cells with lentiviral vectors. Virus Research, 176(1–2), 1–15. https://doi.org/10.1016/j.virusres.2013.05.007. Retrieved November 2025.
6. Sciencedirect Topics. Leukapheresis. Retrieved December 2025.
7. Calmeiro, J., Carrascal, M. A., Tavares, A. R., Ferreira, D. A., Gomes, C., Falcão, A., Cruz, M. T., & Neves, B. M. (2020, February 11). Dendritic cell vaccines for cancer immunotherapy: The role of human conventional type 1 dendritic cells. Pharmaceutics, 12(2), 158. https://doi.org/10.3390/pharmaceutics12020158. Retrieved December 2025.
8. Koski, G. K., Koldovsky, U., Xu, S., Mick, R., Sharma, A., Fitzpatrick, E., Weinstein, S., Nisenbaum, H., Levine, B. L., Fox, K., Zhang, P., & Czerniecki, B. J. (2012, January). A novel dendritic cell-based immunization approach for the induction of durable Th1-polarized anti-HER-2/neu responses in women with early breast cancer. Journal of Immunotherapy, 35(1), 54–65. https://doi.org/10.1097/CJI.0b013e318239c2ce. Retrieved December 2025.
9. Lee, C. (2018, January 29). Distinct features of dendritic cell-based immunotherapy as cancer vaccines. Clinical and Experimental Vaccine Research, 7(1), 16–23. https://doi.org/10.7774/cevr.2018.7.1.16. Retrieved December 2025.
10. Qian, D., Li, J., Huang, M., Cui, Q., Liu, X., & Sun, K. (2023, June). Dendritic cell vaccines in breast cancer: Immune modulation and immunotherapy. Biomedicine & Pharmacotherapy, 162, 114685. https://doi.org/10.1016/j.biopha.2023.114685. Retrieved December 2025.
11. O’Sullivan, C. C., & Chumsri, S. (2025, June 24). Breaking new ground in ductal carcinoma in situ management: The promise of intratumoral messenger ribonucleic acid-2752 and pembrolizumab. Annals of Translational Medicine, 13(3), 25. https://doi.org/10.21037/atm-25-49. Retrieved December 2025.
12. Scott, R. (2023, August 23). Neoadjuvant dendritic cell vaccine–based regimen elicits pCRs in early-stage HER2+ breast cancer. OncLive. Retrieved December 2025.
13. Soliman, H., Aldrich, A., Abdo, N., Han, H., Soyano, A., Costa, R., … Czerniecki, B. (2025, March 17). A pilot study incorporating HER2-directed dendritic cells into neoadjuvant therapy of early stage HER2+ER- breast cancer. npj Breast Cancer, 11, 29. https://doi.org/10.1038/s41523-025-00742-x. Retrieved December 2025.
14. National Comprehensive Cancer Network (NCCN). (2023). NCCN Guidelines for Patients: Invasive Breast Cancer. Retrieved December 2025.
15. Sebastião, A. I., Simões, G., Oliveira, F., Mateus, D., Falcão, A., Carrascal, M. A., Gomes, C., Neves, B., & Cruz, M. T. (2025, January 13). Dendritic cells in triple-negative breast cancer: From pathophysiology to therapeutic applications. Cancer Treatment Reviews, 133, 102884. https://doi.org/10.1016/j.ctrv.2025.102884. Retrieved December 2025.
16. Santisteban, M., Pérez Solans, B., Hato, L., Urrizola, A., Mejías, L. D., Salgado, E., … Inogés, S. (2021, December 23). Final results regarding the addition of dendritic cell vaccines to neoadjuvant chemotherapy in early HER2-negative breast cancer patients: Clinical and translational analysis. Therapeutic Advances in Medical Oncology, 13, 17588359211064653. https://doi.org/10.1177/17588359211064653. Retrieved December 2025.
17. Urrizola, A., Pérez Solans, B., Sánchez-Bayona, R., Mejías, L. D., Hato, L., Salgado, E., … Santisteban, M. (2020, September). 1029P Addition of dendritic cell vaccines to neoadjuvant chemotherapy in HER2 negative breast cancer patients. Annals of Oncology, 31(S4), S710. https://doi.org/10.1016/j.annonc.2020.08.1149. Retrieved December 2025.
18. Organisation for Economic Co-operation and Development (OECD). (2023, November 7). Health at a Glance 2023: Germany – Country note. Retrieved December 2025.
19. European Medicines Agency (EMA). (2020, July 10). Advanced therapy medicinal products: Overview. Retrieved December 2025.
20. Paul-Ehrlich-Institut (PEI). (2025, November 18). Vaccines for humans – Table of vaccines with a valid marketing authorisation. Retrieved December 2025.
21. European Commission. (2017, November 24). Guidelines on Good Manufacturing Practice for Advanced Therapy Medicinal Products. Retrieved December 2025.
22. Fraunhofer Institute for Cell Therapy and Immunology IZI. (2012, July 25). Fraunhofer IZI received manufacturing authorization for DCVax-L Brain. Retrieved December 2025.
23. Valicare GmbH. (2024, April 2). National Exemption: Authorization according to § 4b Abs. 3 AMG. Retrieved December 2025.
24. Xiang, Z., Guo, X., Yin, Z., Li, L., & Wang, Z. (2025). Immunological synapse: structures, molecular mechanisms and therapeutic implications in disease. The Journal of Immunology, 200(2), 443–456. (Article metadata to be verified against full-text access.) Retrieved December 2025.
25. Market Growth Reports. (2025). Dendritic Cell Cancer Vaccines Market – Growth, Trends, and Forecasts (2025–2034). Retrieved December 2025.
26. German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ). (2025). Facts and figures. Retrieved December 2025.
27. Dahl, L., & Walter, S. (2025). CIMT 2025: Report on the 22nd Annual Meeting of the Association for Cancer Immunotherapy. Human Vaccines & Immunotherapeutics. Advance online publication. https://doi.org/10.1080/21645515.2025.2563962. Retrieved December 2025.
28. National Center for Tumor Diseases (NCT) Heidelberg. (2025). The NCT. Retrieved December 2025.
29. Northwest Biotherapeutics, Inc. (2023, June 3). DCVax-L: Mechanism of action, immunological effects, and clinical results – ASCO 2023 slide deck. Retrieved December 2025.
30. National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). (2025). SEER Cancer Stat Facts: Female Breast Cancer. Retrieved December 2025.
31. Solans, B. P., López-Díaz de Cerio, A., Elizalde, A., Pina, L. J., Inogés, S., Espinós, J., et al. (2019, August). Assessing the impact of the addition of dendritic cell vaccination to neoadjuvant chemotherapy in breast cancer patients: A model-based characterization approach. British Journal of Clinical Pharmacology, 85(8), 1670–1683. https://doi.org/10.1111/bcp.13947. Retrieved December 2025.
32. National Breast Cancer Foundation (NBCF). (2025, April 16). Stage 4 breast cancer overview. Retrieved December 2025.
33. Maeng, H. M., Moore, B. N., Bagheri, H., Steinberg, S. M., Inglefield, J., Dunham, K., et al. (2021, December 16). Phase I clinical trial of an autologous dendritic cell vaccine against HER2 shows safety and preliminary clinical efficacy. Frontiers in Oncology, 11, 789078. https://doi.org/10.3389/fonc.2021.789078. Retrieved December 2025.
34. Vassilaros, S., Tsibanis, A., Tsikkinis, A., Pietersz, G. A., McKenzie, I. F. C., & Apostolopoulos, V. (2003). Pilot phase III immunotherapy study in early-stage breast cancer patients using oxidized mannan–MUC1. Cancer Immunology, Immunotherapy. https://doi.org/10.1007/s00262-003-0493-5. Retrieved December 2025.
35. Maeng, H. M., Moore, B. N., Bagheri, H., Steinberg, S. M., Inglefield, J., Dunham, K., et al. (2021, December 16). Phase I clinical trial of an autologous dendritic cell vaccine against HER2 shows safety and preliminary clinical efficacy. Frontiers in Oncology, 11, 789078. https://doi.org/10.3389/fonc.2021.789078. Retrieved December 2025.
36. Dana-Farber Cancer Institute. Vaccination of patients with ovarian cancer with dendritic cell/tumor fusions with GM-CSF and imiquimod (Protocol 07-380). Clinical trial NCT00799110. Retrieved December 2025.
37. Sabado, R. L., Balan, S., & Bhardwaj, N. (2016, December 27). Dendritic cell-based immunotherapy. Cell Research, 27, 74–95 (2017). https://doi.org/10.1038/cr.2016.157. Retrieved December 2025.
38. Schuetz, F., Ehlert, K., Ge, Y., Schneeweiss, A., Rom, J., Inzkirweli, N., Sohn, C., Schirrmacher, V., & Beckhove, P. (2009, June). Treatment of advanced metastasized breast cancer with bone marrow-derived tumour-reactive memory T cells: A pilot clinical study. Cancer Immunology, Immunotherapy, 58(6), 887–900. https://doi.org/10.1007/s00262-008-0605-3. Retrieved December 2025.
39. Domschke, C., Ge, Y., Bernhardt, I., Schott, S., Keim, S., Juenger, S., Bucur, M., Mayer, L., Blumenstein, M., Rom, J., Heil, J., Sohn, C., Schneeweiss, A., Beckhove, P., & Schuetz, F. (2013, June). Long-term survival after adoptive bone marrow T cell therapy of advanced metastasized breast cancer: follow-up analysis of a clinical pilot trial. Cancer Immunology, Immunotherapy, 62(6), 1053–1060. https://doi.org/10.1007/s00262-013-1414-x. Retrieved December 2025.
40. Vassilaros, S., Tsibanis, A., Tsikkinis, A., Pietersz, G. A., McKenzie, I. F. C., & Apostolopoulos, V. (2015). Up to 15-year clinical follow-up of a pilot phase III immunotherapy study in stage II breast cancer patients using oxidized mannan–MUC1. Human Vaccines & Immunotherapeutics, 11(12), 2799–2804. https://doi.org/10.2217/imt.15.48. Retrieved December 2025.
41. Neßelhut, T., Marx, D., & Peters, J. H. (2004, January). Dendritic cell based immunotherapy in a patient with hematogenous metastatic breast cancer. Retrieved December 2025.
42. American Society of Clinical Oncology (ASCO). (2005). Abstract 2528: Dendritic-cell–based immunotherapy in breast cancer (JCO 23(16_suppl):2528). Journal of Clinical Oncology, 23(16_suppl), 2528. https://doi.org/10.1200/jco.2005.23.16_suppl.2528. Retrieved December 2025.
43. Schütz, F., Marmé, F., Domschke, C., Sohn, C., & von Au, A. (2018, March 1). Immunooncology in Breast Cancer: Active and Passive Vaccination Strategies. Breast Care, 13(1), 22–26. https://doi.org/10.1159/000486330. Retrieved December 2025.
44. TranslaTUM – Center for Translational Cancer Research, Technical University of Munich. TranslaTUM: Advancing cancer research through discovery and application. Retrieved December 2025.
45. European Society for Medical Oncology (ESMO). Charité Comprehensive Cancer Center – ESMO host institute. Retrieved December 2025.