Since both trastuzumab and pertuzumab inhibit intracellular Her-2/neu phosphorylation, as well as the phosphorylation of the downstream Akt signaling pathway [24], the upregulation of PD-L1 that was observed following treatment with our multi-peptide vaccine might be the result of a broader binding spectrum of the induced antibodies, thus leading to stronger therapeutic pressure on the receptors expressed on tumor cells [9]. The gene discussed is AKT1; the disease is neoplasm.