Gynecologic oncology
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Gynecologic oncology · Sep 2008
ReviewA review of cross-protection against oncogenic HPV by an HPV-16/18 AS04-adjuvanted cervical cancer vaccine: importance of virological and clinical endpoints and implications for mass vaccination in cervical cancer prevention.
Human papilloma virus (HPV)-16 and -18 are responsible for approximately 70% of invasive cervical cancers worldwide. Other oncogenic HPV types account for almost all the remainder. Importantly, HPV-45 and -31 account for approximately 10%. ⋯ The observed high level of overall protection against clinicopathological lesions, including CIN2+ in the vaccinated subjects (regardless of their HPV DNA status), predicts a potentially broader impact of the vaccine in the prevention of HPV-related precancers that goes beyond HPV-16 and -18. The prevention of persistent infections by individual types such as HPV-45 provides specific information on the protection against that type, using an alternative endpoint that relates to both precancer and cancer development. Together with sustained protection against HPV-16 and -18, protection against HPV-45 could offer an additional effect on invasive cervical cancer and may have an important impact on endocervical adenocarcinoma, which is not effectively prevented by screening and is becoming increasingly important in young women.