Towards therapeutic vaccination against cervical precancer?

Abstract

In The Lancet, Cornelia Trimble and colleagues 1 Trimble CL Morrow MP Kraynyak KA et al. Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting human papillomavirus 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3: a randomised, double-blind, placebo-controlled phase 2b trial. Lancet. 2015; (published online Sept 17.)http://dx.doi.org/10.1016/S0140-6736(15)00239-1 Summary Full Text Full Text PDF Scopus (398) Google Scholar report the results of a double-blind, randomised controlled trial of therapeutic human papillomavirus (HPV) vaccination. Three doses of an intramuscular HPV-16 and HPV-18 plasmid vaccine significantly increased histological regression of cervical precancers caused by HPV types 16 and 18. At 36 weeks after the first dose, regression of cervical intraepithelial neoplasia 2/3 was 48·2% compared with a spontaneous rate in the placebo group of 30·0% (difference 18·2%, 95% CI 1·3–34·4). In 40% of vaccine recipients, HPV DNA became undetectable, compared with about 10% in women who received placebo. The vaccine was well tolerated. Follow-up will assess the durability of the enhanced cell-mediated immune response, and whether it protects against recurrence. Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting human papillomavirus 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3: a randomised, double-blind, placebo-controlled phase 2b trialVGX-3100 is the first therapeutic vaccine to show efficacy against CIN2/3 associated with HPV-16 and HPV-18. VGX-3100 could present a non-surgical therapeutic option for CIN2/3, changing the treatment outlook for this common disease. Full-Text PDF