HPV: The vaccine would be effective in women being in the first stages of cervical cancer

“Almost all pre-malignant cervical lesions and cervical cancers are caused by a human papillomavirus infection (HPV), HPV16 being involved in the majority of cases”, said Refika YigitOncologist gynecologist at the University Medical Center of Groningue (Netherlands). In people with an intraepithelial grade 3 intraepithelial neoplasia (CIN3), corresponding to a precancerous state of the cervix, the cells are already in the process of malignancy. If they are not treated, about a third of these cases evolve towards cervical cancer in 10 years and about half in 30 years.

HPV: 3 doses of vvax001 injected into women with a precancerous state of the cervix

Currently, the management of this cervical dysplasia is based on electrosurgical excision at the Anse Diathermique (LEEP). During this intervention, a slim metal wire handle is used to remove the abnormal fabric of the cervix. Problem: it is associated with complications. This is why Refika Yigit and a team of researchers wanted to assess the effectiveness of a vaccine targeting the human papillomavirus type 16 (HPV16), which is called “VVAX001.” The latter “is a modified version of the Semliki forest virus which cannot be replicated and produces the E6 and E7 oncogenic proteins which are expressed exclusively by cells infected with HPV16”, they said.

As part of a study, published in the journal Clinical Cancer Researchscientists recruited 18 women who recently received a diagnosis of cervical intraepithelial neoplasia of grade 3 HPV16-post. The participants received three doses of VVax001 to three weeks apart, then were systematically monitored by colposcopy before a final biopsy guided by colposcopy at 19 weeks after vaccination. “Histopathological response rates, HPV16 clearance, unwanted processing events (trae) and immune responses induced by the vaccine have been assessed.”

In 94 % of patients, the vaccine decreases the size of precancerous cervical lesions

The colposcopic examination revealed a reduction in the size of precancerous cervical lesions in 17 patients, or 94 %, which was already obvious three weeks after the last vaccination. A regression to an intraepithelial grade 1 (CIN1) intraepithelial neoplasia or an absence of dysplasia has been observed in nine volunteers. Another observation: ten participants eliminated HPV16, including nine patients whose disease has regressed. Two patients whose disease has not regressed also eliminated HPV16. However, their lesions housed other HPV strains.

According to the authors, the nine people whose pathology has not decreased have undergone electrochurgeular excision to the diathermic handle, although no residual disease has been found in four of these patients, “This suggests that the additional time before surgery could have allowed complete eradication of lesions.” To date, no recurrence has been noted, with median survival and maximum survival of 20 and 30 months, respectively. Likewise, no serious side effects have been observed.

“Half of patients with Cin3 could avoid surgery”

“To our knowledge, this response rate makes the VVax001 one of the most effective therapeutic vaccines against CIN3 lesions associated with the HPV16 reported. If confirmed in a larger trial, our results could mean that at least half Patients with Cin3 could be able to avoid surgery and avoid all of its possible side effects and complications “, concluded Refika Yigit.