---

Adjuvants are an essential component of modern vaccines. An adjuvant is an entity added to a vaccine formulation to ensure that robust immunity to the antigen is inoculcated. The adjuvant is typically vital for the efficacy of vaccines using subunit (pepdids, proteins and virus like particles) and DNA antigens. Furthermore, these components are used to reach the current new goals of preventing and/ or treating chronic infectious diseases and cancers. This review focuses on formulation aspects of adjuvants, safety considerations, progress in understanding their mechanisms of action and also their side effects with using 97 articles are acceceble in pubmed central and google scholar indexing which published during 1980-2016. Adjuvants can be broadly divided into two classes, based on their principal mechanisms of action; the first class are vaccine delivery systems that generally particulate and mainly function to target associated antigens into antigen presenting cells. The others are immunostimulatory adjuvants that predominantly derived from pathogens and often represent pathogen associated molecular patterns which activate cells of the innate immune system. Adjuvants induce cellular and humoral responses, in particular neutralizing antibodies that able to inhibit the binding of pathogens to their cellular receptors. Efficient Th1-immunity-inducing adjuvants are highly in demand. The adjuvants promote good cell-mediated immunity against subunit vaccines that have low immunogenicity themselves. However, attempts to develop a new generation of adjuvants, which are essential for new vaccines, is important, but their use is limited because, little is known about their mechanisms of action and health risks.

---

Background and Objective: Breast cancer has a high prevalence and mortality rate in the world and also in Iran. Neoadjuvant chemotherapy (NAC) is one of the treatment methods to improve patient survival. This study aimed to determine the response rate to NAC in patients with locally advanced breast cancer based on common molecular receptors.
Methods: This descriptive-analytical study was conducted on 100 patients with breast cancer (mean age= 41.14±10.06 years) referring to the surgical clinic of the Fifth Azar Educational and Therapeutic Center in Gorgan, Iran during 2013-18. Patients without distant metastasis underwent NAC treatment regimen followed by surgery. Demographic characteristics, types of drugs, and molecular receptor characteristics, and their response to treatment were recorded in a checklist. Treatment response and overall patient survival were evaluated.
Results: The mean tumor size before NAC was 3.01±2.47 cm (range= 0-8, median= 2) and 16% were determined to be grade one, 52% were determined to be grade 2, and 32% were determined to be grade 3. Thirty-six percent of patients had a positive family history. Forty-six percent were estrogen receptor (ER) positive, 40% were PR positive, 22% were human epidermal growth factor receptor 2 (Her-2) positive, and 78% were Her-2 negative. Thirty-six percent had a Ki-67 index greater than 30%. Eighteen percent of patients had a complete pathological response, and 82% had a partial or negative response. In terms of family history of breast cancer, Her2, ER, progestrone receptor (PR), Ki-67 receptor status, histological grade, tumor size, and axillary lymph nodes, there was a significant statistical difference between the two groups with and without complete pathological response (P<0.05).
Conclusion: The rate of complete pathological response to NAC in patients with locally advanced breast cancer was 18%.