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Next-Generation HPV Vaccine May Prevent 90% of Cervical Cancer Cases Worldwide

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Key Points

  • A study of a nine-valent human papillomavirus vaccine that provides protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, has found it to be highly safe and efficacious.
  • If vaccination programs with this new-generation vaccine are effectively implemented, approximately 90% of invasive cervical cancer cases worldwide could be prevented.
  • Despite the safety profile of HPV vaccines, uptake in the United States and other resource-rich countries has been inadequate.

A study of a nine-valent human papillomavirus (HPV) vaccine that provides protection against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58, has found it to be highly safe and efficacious. If vaccination programs with this new-generation vaccine are effectively implemented, approximately 90% of invasive cervical cancer cases worldwide could be prevented, according to the researchers. The study by Joura et al is published in Cancer Epidemiology, Biomarkers & Prevention.

Study Methodology

The researchers used data from 10,656 women aged 15 to 26 and 1,858 women aged 24 to 45 enrolled in the placebo arms of one of three clinical trials of a quadrivalent HPV vaccine. Among these women, 2,507 were diagnosed with CIN1, CIN2, CIN3, or adenocarcinoma in situ. The researchers estimated the number of precancers harboring the HPV types included in an investigational nine-valent HPV vaccine currently under review with the U.S. Food and Drug Administration (FDA).

Study Findings

After adjusting for the presence of multiple HPV subtypes in a single lesion, the researchers found that seven high-risk HPV types included in the nine-valent HPV vaccine were present in about 55% of CIN1, about 78% of CIN2, about 91% of CIN3, and nearly 100% of adenocarcinoma in situ lesions.

Of the women ages 15 to 26 who had precancers, 54% had a single HPV infection and 32% had more than one HPV type. Of the women ages 24 to 45 with precancers, 59% and 19% were infected with one or more HPV types, respectively.

“Given the high vaccine efficacy that was observed in a large phase III clinical trial testing the nine-valent HPV vaccine, if vaccination programs with this new-generation vaccine are effectively implemented, approximately 90% of invasive cervical cancer cases worldwide could be prevented, in addition to the majority of precancerous lesions,” said Elmar A. Joura, MD, Associate Professor of Gynecology at the Medical University of Vienna in Austria, and lead author of the study, in a statement.

HPV types 16 and 18 are the predominant causative factors of cervical precancers, which are referred to as CIN1, 2, and 3 depending on the extent of abnormality. In 2011, the International Agency for Research on Cancer expanded the carcinogens list to include HPV types 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59.

“Despite the clear safety profile of the currently disseminated HPV vaccines, uptake in the United States and other resource-rich countries has been inadequate,” concluded the researchers. “To achieve the population level potential of HPV vaccine to reduce cancer, vaccine uptake must increase.” 

Dr. Joura is the corresponding author for the Cancer Epidemiology, Biomarkers & Prevention article.

The study was funded by Merck and Co. Dr. Joura received grant support from Merck and GlaxoSmithKline PLC, advisory fees from Merck and GlaxoSmithKline PLC, and lecture fees from Sanofi Pasteur MSK, Merck, and Roche. For full disclosures of the study authors, visit cebp.aacrjournals.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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