Trial of HPV vaccine completed: more effective cancer prevention
2 March 2015
A new HPV (human papilloma virus) vaccine that protects against 9 types of the virus – 7 of which cause most cases of cervical cancer – has now been fully tested in a trial co-organised by Professor Jack Cuzick.
The new vaccine offers significantly greater protection than the current vaccine, which protects against only two cancer-causing types of HPV.
The importance of prevention
Cervical cancer is still the fourth most common cancer in women, with over 500,000 cases and 250,000 deaths per year worldwide. In the UK around 3,000 women a year are diagnosed with cervical cancer and in 2011 there were around 970 deaths.
In the UK, all girls aged 12 to 13 are offered HPV vaccination as part of the NHS childhood vaccination programme.
A pivotal international clinical trial compared the safety and efficacy of a new vaccine, Gardasil 9, with the current vaccine, Gardasil, in more than 14,200 women aged 16 – 26. The results show that if uninfected populations are vaccinated with Gardasil 9, approximately 90% of all cervical cancers worldwide could be prevented.
Published in the New England Journal of Medicine, the study found that Gardasil 9 was 97% effective at preventing high-grade cervical, vulvar and vaginal disease caused by HPV strains 31, 33, 45, 52 and 58, and was equally effective as the current Gardasil vaccine in preventing diseases caused by HPV 6, 11, 16 and 18 – in uninfected women.
Professor Jack Cuzick from the Centre for Cancer Prevention, part of the BartsCR-UK Centre together with BCI, co-authored the report and participated in the design and analysis of the study. He also served on the Trial Advisory Board, and said:
“This is a significant achievement. The new vaccine, Gardasil 9, is not only safe but will offer greatly improved protection against cervical and other cancers. Eventually this will mean less screening is needed, as women will have greater protection from the outset.
“Gardasil 9 offers the potential to increase overall cervical cancer prevention from 70 to 90 per cent, nearly eliminating this cancer among vaccinated women. However, it’s crucial to remember that vaccination must be done before exposure to the virus.
“Our focus for prevention must be on girls aged 12-13, as the current UK vaccine programme is doing, but the vaccine may also be appropriate for women 25-45 as part of a screening appointment.”
Advances in prevention
Until late last year, there were two available vaccines to protect against HPV related disease: Cervarix and Gardasil. The UK currently uses Gardasil which protects against four HPV strains and offers around 70% protection against cervical cancer, while also significantly reducing the risk of other types of cancer and genital warts.
However, researchers have been working on methods to completely eliminate cervical cancer and other HPV-related disease; by adding five more cancer-related HPV types to the vaccine’s targets, the development of Gardasil 9 makes an important step in that direction.
HPV is the most common sexually transmitted virus. Most people infected with HPV clear it from their system with no lasting health concerns. Some types of the virus are low risk, causing warts or verrucas. However, other types are high risk, causing cervical cancer (and, less commonly: vulvar, vaginal, penile, anal, and throat cancers). Almost all cases of cervical cancer occur as a result of infection with high risk types of HPV.
Professor Cuzick added:
“Following these important findings, this vaccine has been licenced in the USA and approval is currently being sought in the UK and other countries. It is encouraging that the Joint committee on Vaccines and Immunisation is reviewing Gardasil 9 in light of this new evidence.”
This clinical trial was funded by Merck.
The Times - Vaccine stops 90% of cervical cancers
Medical Xpress - New HPV vaccine offers greater protection against cervical cancer than current vaccine
LA Times- Vaccine that targets 9 strains of HPV boosts cancer protection, study says
CTV News - Health Canada approves new, more potent HPV vaccine
Health News Digest - New Vaccine Against HPV Infections can Prevent 90 per cent of Conditions Caused by HPV
Malay Mail Online - Study: New HPV vaccine more effective, protects against 90pc of all cervical cancers
Healio - 9-valent HPV vaccine noninferior to quadrivalent HPV vaccine
Ouest France - Papillomavirus. Un nouveau vaccin efficace à 90%, selon une étude
A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women
EA Joura, AR Giuliano, OE Iversen, C Bouchard, C Mao, J Mehlsen, ED Moreira, Y Ngan, LK Petersen, E Lazcano-Ponce, P Pitisuttithum, JA Restrepo, G Stuart, L Woelber, YC Yang, J Cuzick, SM Garland, W Huh, SK Kjaer, OM Bautista, ISF Chan, J Chen, R Gesser, E Moeller, M Ritter, S Vuocolo, A Luxembourg. (2015) NEJM. 372:711-723. PMID: 25693011
With thanks to Marianne Baker