D. GM-CSF rhuGM -CSF (Sargramostatin, LEUKINE) will be used as the vaccine adjuvant. GM -CSF is a growth factor that supports the survival, clonal expansion, and differentiation of hematopoietic prog enitor cells including dendritic antigen presenting cells. The use of GM -CSF in humans has been associated with minor toxicity. GM -CSF has been given s.c. at the same dose and schedule without noted apparent differences in toxicities. In some studies the toxicity profile for s.c. administration has been more favorable than for i.v. For the current study GM -CSF will be used at a total injection dose of 100 mcg mixed prior to injection with HER2 CTL vaccine and injected i.d. at the time of immunization. Local effects at the injection site are not expected with this dose of GM -CSF. Recombinant GM -CSF (rhuGM -CSF) is generally well tolerated when administered i.v. or s.c. in doses ranging from 50- 500 mcg /m 2/day. Severe toxicity is extremely rare in subjec ts treated with rhuGM -CSF. Diarrhea, asthenia, rash, and malaise were the only events observed in more than 5% of the rhuGM -CSF group compared with the placebo group in phase III controlled studies of subjects undergoing autologous bone marrow transplan tation. In uncontrolled phase I/II studies for various indications, the adverse effects report most frequently were fever, chills, nausea, vomiting, asthenia, headache and pain in the bones, chest, abdomen, joints, or muscles. Most of these systemic even ts were mild to moderate in severity and rapidly reversed by the administration of analgesics or antipyretics. Other events reported infrequently were dyspnea, edema, local injection site reactions, and rash. Thrombosis and cardiac arrhythmia have also b een reported and there have been infrequent reports of tissue sloughing, leukemia progression, congestive heart failure, hepatomegaly, intracranial bleeding, and isolated reports of Guillain- Barre syndrome and increased histiocytes. Neutropenia, although usually a pre -existing condition in the subjects receiving rhuGM -CSF, has been reported in association with administration. There was an increased frequency of severe thrombocytopenia in subjects receiving concurrent chemotherapy and radiotherapy with rhuGM -CSF. Eosinophilia and other blood abnormalities may occur. There have been rare reports of: 1) sequestration of granulocytes in the lungs with respiratory symptoms; 2) a syndrome characterized by respiratory distress, hypoxia, flushing, orthostatic hypotension, and partial loss of consciousness; 3) peripheral edema, pericardial or pleural effusions, and capillary leak of fluid; and 4) serious allergic or anaphylactic reactions. Administration of rhuGM -CSF may aggravate fluid retention in subjects wit h pre -existent edema, capillary leak syndrome, or pleural or pericardial effusions. In some subjects with pre -existing renal or hepatic dysfunction, elevation of the serum creatinine or bilirubin and hepatic enzymes has occurred during the administration of rhuGM -CSF. Dose reduction or interruption or rhuGM -CSF administration has resulted in a decrease to pretreatment values. Occasional transient and reversible supraventricular arrhythmia has been reported in uncontrolled studies, particularly in subject s with a previous history of cardiac arrhythmia. Stimulation of marrow precursors with rhuGM -CSF may result in a rapid rise in white blood cell count. Dosing should be 6304p Protocol 118 04/06/2016 stopped if the ANC exceeds 20,000/cm3. rhuGM -CSF may stimulate the growth of myeloid malignancies, therefore caution must be exercised in its use in the malignancies or myelodysplastic syndromes. rhuGM -CSF is a sterile, white, preservative -free lyophilized powder in 250 mcg vials. Reconstituted rhuGM - CSF will be admixed with the vaccin e product, HER2 CTL vaccine, and injected at a dose of 100 mcg (0.2 ml rhuGM -CSF). E. Final vaccine preparation The vaccine is vialed and stored at a concentration of 1.9 mg/ml peptide in a volume of 1.1 ml/vial (2.1 mg total) . The peptides have been reconstituted in 10mM sodium acetate with 17.8% (v/v) DMSO. The vaccines are stored at - 20°C prior to use. Prior to administration, 150 mcg of rhuGM -CSF (0.3 ml) is added to a single vial of the CTL vaccine bringing the total volume in the vial to 1.4 ml. Thus, the vaccine concentration after the addition of adjuvant is 2.1 mg/1.4 ml. The final dose of peptide vaccine to be delivered is 1.5 mg (500 mcg/each peptide) with 100 mcg GM -CSF. The vaccine will be administered as three intradermal injections, 0. 33 ml each, within a 5 cm radius in the same draining lymph node basin. 6.