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Vaccines: The Next Step for Cervical Cancer Prevention?

Katherine Arnold

Once we know how to use information from human papillomavirus tests to effectively test and treat women for cervical abnormalities, what is next?

"Vaccines," said Mark Schiffman, M.D., of the National Cancer Institute’s Division of Cancer Epidemiology and Genetics. "[Cervical cancer] should be a vaccine-preventable cancer."



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Dr. Mark Schiffman

 
In this issue of the Journal, an international team of investigators report the results of a phase I safety study of an HPV16 L1 virus-like particle vaccine (see article, p. 284). As expected, the vaccine was well tolerated, and all patients developed an immune response to HPV. (HPV16 is found in about 50% of all cervical cancers; types 18, 31, and 35 account for an additional 25% to 30% of the cancers.)

"The key question is whether one of these vaccine approaches will be effective in preventing HPV-associated disease or parameters that are associated with the disease," said NCI’s Doug Lowy, M.D., one of the study’s authors. "If it were effective and you could make a multivalent vaccine, then it could have a very significant impact on HPV-associated disease."

And answering that key question is the next step. This summer, under the direction of Allan Hildesheim, Ph.D., and his colleagues, NCI will launch a trial to test this vaccine and one other in more than 10,000 women in Costa Rica. Researchers will collect information on side effects, immune induction, and the occurrence of cervical disease.

"Cervical cancer is the best understood neoplasia, moving from a normal state all the way to cancer; therefore, it provides many interception points for prevention," said Schiffman, who is also a project officer for ALTS (see related story). "We have the possibility to wipe out this horrible cancer, and we could set our minds to eliminating it in our generation."



             
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