3016 Background: HER2/neu is overexpressed in breast cancer (BCa) and is the source of immunogenic peptides. CD4+ T helper peptides for HER2/neu are being evaluated in vaccine trials. The addition of Ii-Key, a 4-amino-acid LRMK modification, increases vaccine potency when compared to unmodified class II epitopes. We present the results of the first human Phase I trial of the Ii-Key hybrid HER2/neu peptide (AE37) vaccine in disease-free, node-negative BCa patients. Methods: The dose-escalation trial included 5 dose groups, to determine safety and optimal dose of the hybrid peptide (100mcg; 500 mcg; 1,000mcg) and GM-CSF (range 0–250mcg). In the event of significant toxicity, GM-CSF (or peptide in the absence of GM-CSF) was reduced by 50%. Immunologic response was monitored by DTH and 3H-thymidine proliferative assays for both the hybrid AE37 (LRMK + HER2/neu:776–790) and AE36 (unmodified HER2/neu:776–790). Results: All 15 patients completed the trial with no grade 3–5 local or systemic toxicities. Dose reductions occurred in 47% of patients for local reactions ≥100mm or grade 2 systemic toxicities. The second group (peptide=500mcg, GM-CSF=250mcg) all required dose reductions prompting peptide-only inoculations in the third group (peptide=1,000mcg, GM-CSF=0mcg). AE37, with and without GM-CSF, elicited dose-dependent immunologic responses in vitro and in vivo to both AE37 and AE36 albeit AE37 responses were more robust. Assessing both toxicities and immunologic responses, the hypothesized optimal biologic dose was determined as peptide=500mcg, GM-CSF=62.5mcg, in 6 monthly injections. Conclusions: The hybrid AE37 vaccine appears safe and well tolerated with minimal local or systemic toxicity if properly dosed. AE37 is capable of eliciting HER2/neu-specific immune responses, even without the use of an adjuvant. This trial represents the first human experience with the Ii-Key modification, and to our knowledge, AE37 is the first peptide-based cancer vaccine to show potency in the absence of an immunoadjuvant. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Antigen Express, Inc. Antigen Express, Inc. Antigen Express, Inc.