This Article Full Text Full Text (PDF) CME: Take the course for this article: Vaccines Against Human Papillomavirus and Cervical Cancer: Promises and Cha... eLetters: Submit a response to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mahdavi, A. Articles by Monk, B. J. Search for Related Content PubMed PubMed Citation Articles by Mahdavi, A. Articles by Monk, B. J.

Vaccines Against Human Papillomavirus and Cervical Cancer: Promises and Challenges

Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California, Irvine, Orange, California, USA

Correspondence: Bradley J. Monk, M.D., Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California, Irvine, 101 The City Drive, Building 56, Room 262, Orange, California 92868-3298, USA. Telephone: 714-456-7974; Fax: 714-456-6463; e-mail: bjmonk{at}uci.edu

Cervical cancer and precancerous lesions of the genital tract are major threats to the health of women worldwide. The introduction of screening tests to detect cervical cancer precursor lesions has reduced cervical cancer rates in the developed world, but not in developing countries. Human papillomavirus (HPV) is the primary etiologic agent of cervical cancer and dysplasia. Thus, cervical cancer and other HPV-associated malignancies might be prevented or treated by HPV vaccines. Two vaccine strategies have been developed. First, prevention of HPV infection through induction of capsid-specific neutralizing antibodies has been studied in clinical trials. However, because the capsid proteins are not expressed at detectable levels by infected basal keratinocytes or in HPV-transformed cells, a second approach of developing therapeutic vaccines by targeting nonstructural early viral antigens has also been developed. Because two HPV oncogenic proteins, E6 and E7, are critical to the induction and maintenance of cellular transformation and are coexpressed in the majority of HPV-containing carcinomas, most therapeutic vaccines target one or both of these gene products. A variety of approaches is being tested in therapeutic vaccine clinical trials, whereby E6 and/or E7 are administered in live vectors, as peptides or protein, in nucleic acid form, or in cell-based vaccines. The paradigm of preventing HPV infection through vaccination has been tested, and two vaccines are currently in phase III clinical trials. However, current therapeutic vaccine trials are less mature with respect to disease clearance. A number of approaches have shown significant therapeutic benefit in preclinical papillomavirus models and await testing in patient populations to determine the most effective curative strategy.

Key Words. Human papillomavirus • Vaccine • Cervical cancer • Cervical dysplasia

This article has been cited by other articles:

				H. Liu, B. H. Wu, G. J. Rowse, and P. C. R. Emtage Induction of CD4-Independent E7-Specific CD8+ Memory Response by Heat Shock Fusion Protein Clin. Vaccine Immunol., August 1, 2007; 14(8): 1013 - 1023. [Abstract] [Full Text] [PDF]

				B. J. Monk, K. S. Tewari, and W.-J. Koh Multimodality Therapy for Locally Advanced Cervical Carcinoma: State of the Art and Future Directions J. Clin. Oncol., July 10, 2007; 25(20): 2952 - 2965. [Abstract] [Full Text] [PDF]

				M. R. Gabri, Z. Mazorra, G. V. Ripoll, C. Mesa, L. E. Fernandez, D. E. Gomez, and D. F. Alonso Complete Antitumor Protection by Perioperative Immunization with GM3/VSSP Vaccine in a Preclinical Mouse Melanoma Model Clin. Cancer Res., December 1, 2006; 12(23): 7092 - 7098. [Abstract] [Full Text] [PDF]

				D. van Hamont, M. A. P. C. van Ham, J. M. J. E. Bakkers, L. F. A. G. Massuger, and W. J. G. Melchers Evaluation of the SPF10-INNO LiPA Human Papillomavirus (HPV) Genotyping Test and the Roche Linear Array HPV Genotyping Test. J. Clin. Microbiol., September 1, 2006; 44(9): 3122 - 3129. [Abstract] [Full Text] [PDF]

				B. J. Monk and D. J. Wiley Will Widespread Human Papillomavirus Prophylactic Vaccination Change Sexual Practices of Adolescent and Young Adult Women in America? Obstet. Gynecol., August 1, 2006; 108(2): 420 - 424. [Abstract] [Full Text] [PDF]

				G. J. Kelloff, S. M. Lippman, A. J. Dannenberg, C. C. Sigman, H. L. Pearce, B. J. Reid, E. Szabo, V. C. Jordan, M. R. Spitz, G. B. Mills, et al. Progress in Chemoprevention Drug Development: The Promise of Molecular Biomarkers for Prevention of Intraepithelial Neoplasia and Cancer--A Plan to Move Forward Clin. Cancer Res., June 15, 2006; 12(12): 3661 - 3697. [Abstract] [Full Text] [PDF]

				I. de Melo-Martin The promise of the human papillomavirus vaccine does not confer immunity against ethical reflection. Oncologist, April 1, 2006; 11(4): 393 - 396. [Abstract] [Full Text] [PDF]