Opportunities to improve immune-based prevention of HPV-associated cancers
AffiliationDivision of Molecular & Clinical Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Cancer Research Centre, University of Manchester, Wilmslow Road, Manchester, M20 4BX,
MetadataShow full item record
AbstractImmunization of adolescent girls with VLP vaccines, made of L1 proteins from the most medically significant high risk HPV types, is a major strategy for prevention of cervical cancer plus other HPV-associated cancers. Maximal population impact, including through herd immunity, requires high vaccination coverage. However, protection of unvaccinated women requires secondary prevention through cytology screening. Unfortunately in countries with the highest incidence/mortality due to cervical cancer HPV vaccination (or cytology screening) is not sufficiently available. Vaccination programme costs and a lack of accessibility of the populations for immunization remain significant hurdles. Several approaches could increase effective implementation of HPV vaccination. 1) Use of a single immunization of the current VLP vaccines. 2) Vaccination bundled with other paediatric vaccines with lower dosage to facilitate delivery, improve coverage and reduce costs through established logistics. 3) Local manufacture with lower cost systems (e.g. bacteria) for VLP or capsomer based vaccine production and utilization of additional protective epitopes (e.g L2) for increasing breadth of protection. However, all the latter need appropriate clinical validation. Gender neutral vaccination and extending routine vaccination strategies to women up to age 30 years in combination with at least one HPV screening test can also hasten impact on cancer incidence.
CitationStern PL, Roden RB. Opportunities to improve immune-based prevention of HPV-associated cancers. Papillomavirus Res. 2019 Apr 11;7:150-3.
- The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomised trial cohort through three screening rounds.
- Authors: C Kitchener H, Canfell K, Gilham C, Sargent A, Roberts C, Desai M, Peto J
- Issue date: 2014 Apr
- Gender-neutrality, herd effect and resilient immune response for sustainable impact of HPV vaccination.
- Authors: Lehtinen M, Apter D
- Issue date: 2015 Oct
- Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis.
- Authors: Drolet M, Bénard É, Boily MC, Ali H, Baandrup L, Bauer H, Beddows S, Brisson J, Brotherton JM, Cummings T, Donovan B, Fairley CK, Flagg EW, Johnson AM, Kahn JA, Kavanagh K, Kjaer SK, Kliewer EV, Lemieux-Mellouki P, Markowitz L, Mboup A, Mesher D, Niccolai L, Oliphant J, Pollock KG, Soldan K, Sonnenberg P, Tabrizi SN, Tanton C, Brisson M
- Issue date: 2015 May
- Cost-effectiveness of HPV vaccination in the context of high cervical cancer incidence and low screening coverage.
- Authors: Võrno T, Lutsar K, Uusküla A, Padrik L, Raud T, Reile R, Nahkur O, Kiivet RA
- Issue date: 2017 Nov 1
- A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool.
- Authors: Hutubessy R, Levin A, Wang S, Morgan W, Ally M, John T, Broutet N
- Issue date: 2012 Nov 13