From OncoLog, April 2006, Vol. 51, No. 4
DiaLog: The Revolutionary Cervical Cancer Vaccine
Therese B. Bevers, M.D., Medical Director, Cancer Prevention Center
The cervical cancer vaccine is ground-breaking and has the potential to significantly reduce the incidence of cervical cancer, the second most deadly cancer in women worldwide, causing 300,000 deaths a year. The University of Texas M. D. Anderson Cancer Center supports any proven cancer prevention strategy and is excited by the promise of this new vaccine to make a meaningful difference.
The vaccine prevents infection from two subtypes of human papillomavirus (HPV) that are strongly associated with cervical cancer. Studies have shown that the vaccine can reduce the risk of infection from HPV by over 90%. Efficacy with regard to prevention of clinical disease has been reported as high as 100% in short-term studies. Two vaccines, each slightly different, are being investigated by two pharmaceutical companies. Merck’s version (Gardasil) is a quadrivalent vaccine that includes two HPV subtypes (16 and 18) that cause 70% of cervical cancers and two HPV subtypes (6 and 11) that are associated with genital warts. Merck’s vaccine is undergoing priority review at the Food and Drug Administration, which is expected to be completed in June of this year. GlaxoSmithKline’s vaccine (Cervarix), which is in phase III trials, is a bivalent vaccine of strains 16 and 18.
I had the exciting opportunity to participate on an advisory board for Merck as it explored the implementation of its vaccine into the general population. It is still being determined at what age the vaccine series (three injections in a 6-month period) will be given, but it must be given before a girl becomes sexually active and possibly exposed to HPV. Eventually, as the vaccines are studied more, they may be available for younger girls and may even become part of childhood immunizations, but for now, studies have only been conducted in women over 16 years old.
Once girls start receiving the vaccine, we are likely to see the incidence of cervical dysplasia decrease because the HPV infection will have been prevented. Because of this, in decades to come, we will need to re-examine the role of Pap smears.
While we have 3700 deaths a year from cervical cancer in the U.S., this rate is very low compared with that in developing countries, which lack screening and treatment facilities. The vaccine can make a profound difference in the developing world and reduce death rates from this cancer.
It’s phenomenal to trace how far science has come in the prevention of cervical cancer. In the 1930s, it was the leading cause of cancer deaths in the U.S. Then, with the advent of the Pap smear in the 1930s, we were able to test for and treat cellular abnormalities; since 1955, deaths from cervical cancer have significantly declined. And now, with the promise of the cervical cancer vaccine, we are on the verge of another revolution in the prevention of this cancer.For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
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