Volume 44, Issue 3 , Pages 232-241, September 2005
Human Papillomavirus Vaccine for Cervical Cancer: Where Are We Now?
Article Outline
Summary
Globally, cervical cancer is one of the most common cancers in women, representing up to 25% of all female cancers, and is the most common cancer in developing countries. It kills around 250,000 women every year worldwide and around 1,000 in Taiwan. Cervical cancer is largely preventable through screening programs to diagnose cervical lesions that may progress to invasive cancer. It has recently been definitively linked to genital human papillomavirus (HPV) infections. HPV fulfills the criteria for a carcinogenic agent defined by the International Agency for Research on Cancer. More than 200 types of HPV have been identified by DNA sequence data, and 85 HPV genotypes have been well characterized to date. HPV can infect the basal epithelial cells of the skin or inner tissue linings and is, accordingly, categorized as either cutaneous or mucosal. Genital HPV infections are now recognized as a major risk factor in at least 95% of cervical cancers. Thirty different HPV genotypes have been identified as causative of sexually transmitted diseases, most of which induce lesions in the cervix, vagina, vulva, penis, and anus. The main aim of this review is to evaluate the current literature regarding the relationship between HPV and cervical neoplasm, host immune responses to HPV, and the current status of preventive and therapeutic HPV vaccines.
Key Words: cervical cancer , human papillomavirus , vaccine
No full text is available. To read the body of this article, please view the PDF online.
References
- Safety and immunogenicity trial in adult volunteers of a human papillomavirus 16 L1 virus-like particle vaccine . J Natl Cancer Inst . 2001;93:284–292
- 2004, W.H.R. Changing History. Statistical annex. World Health Organization, http://www.who.int/whr/2004/en/index.htm
- 2000 Cancer Registration Report. Department of Health, Executive Yuan, Taiwan.
- . Can screening for cervical cancer be improved, especially in developing countries? . Int J Cancer . 2003;107:337–340
- IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Human Papillomaviruses, Volume 64 . Lyon: International Agency for Research on Cancer Press; 1995;
- . The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States-a 24-year population-based study . Gynecol Oncol . 2000;78:97–105
- . Epidemiology of cervical cancer . Cancer Invest . 2000;18:584–590
- Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group . J Natl Cancer Inst . 1995;87:796–802
- . Epidemiology of cervical cancer in Taiwan . Gynecol Oncol . 1996;62:344–352
- . Effectiveness of screening for cervical cancer in Taiwan. A case-control study . Zhonghua Yi Xue Za Zhi (Taipei) . 1992;49:81–85 [In Chinese]
- . Risk factors for recurrence in patients with stage IB, IIA, and IIB cervical carcinoma after radical hysterectomy and postoperative pelvic irradiation . Obstet Gynecol . 1996;88:274–279
- . The genotypes and prognostic significance of human papillomaviruses in cervical cancer . Int J Cancer . 1994;57:181–184
- Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer . J Clin Oncol . 2000;18:1740–1747
- . A comparison review of key epidemiological studies in cervical cancer related to current searches for transmissible agents . Cancer Res . 1973;33:1353–1367
- Male sexual behavior and human papillomavirus DNA: key risk factors for cervical cancer in Spain . J Natl Cancer Inst . 1996;88:1060–1067
- . Chapter 1: Human papillomavirus and cervical cancer-burden and assessment of causality . J Natl Cancer Inst Monogr . 2003;3–13
- . The causal relation between human papillomavirus and cervical cancer . J Clin Pathol . 2002;55:244–265
- Chlamydia trachomatis infection as a risk factor for invasive cervical cancer . Int J Cancer . 2000;85:35–39
- . Cervical cancer. Current view of its epidemiology and risk factors . Ginecol Obstet Mex . 2004;72:466–474 [In Spanish]
- . Cervical cancer in the Asia Pacific-epidemiology, screening and treatment . Asian Pac J Cancer Prev . 2004;5:349–361
- . The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today . J Natl Cancer Inst . 1981;66:1191–1308
- . The human papillomaviruses . Bull Cancer . 1978;65:151–164
- . Immunology of the human papilloma virus in relation to cancer . Curr Opin Immunol . 1994;6:746–754
- . The full-length E6 protein of human papillomavirus type 16 has transforming and trans-activating activities and cooperates with E7 to immortalize keratinocytes in culture . J Virol . 1991;65:4860–4866
- . Correlation of modified human papilloma virus early gene expression with altered growth properties in C4–1 cervical carcinoma cells . Cancer Res . 1988;48:3780–3786
- . The E6 and E7 genes of human papillomavirus type 6 have weak immortalizing activity in human epithelial cells . J Virol . 1992;66:2125–2134
- . Human papillomavirus immortalization and transformation functions . Virus Res . 2002;89:213–228
- . Human papillomavirus and lower genital neoplasia in renal transplant patients . Obstet Gynecol . 1986;68:251–258
- . The increased frequency of cervical dysplasia-neoplasia in women infected with the human immunodeficiency virus is related to the degree of immunosuppression . Am J Obstet Gynecol . 1991;164:593–599
- Genital papillomavirus infection and cervical dysplasia-opportunistic complications of HIV infection . Int J Cancer . 1992;50:45–48
- . Animal models for HPV vaccine development . Papillomavirus Report . 1994;5:105–111
- . Regression of papillomas induced by cottontail rabbit papillomavirus is associated with infiltration of CD8+ cells and persistence of viral DNA after regression . J Virol . 1997;71:5540–5548
- Systemic immunization with papillomavirus L1 protein completely prevents the development of viral mucosal papillomas . Proc Natl Acad Sci USA . 1995;92:11553–11557
- . Regression of flat warts and common warts . Clin Dermatol . 1985;3:170–178
- . Human papilloma-virus in the immunosuppressed . Papillomavirus Report . 1992;3:23–26
- . Definition of murine T helper cell determinants in the major capsid protein of human papillomavirus type 16 . J Gen Virol . 1990;71:2691–2698
- . Identification of T- and B-cell epitopes of the E7 protein of human papillomavirus type 16 . J Virol . 1991;65:4681–4690
- . A “public” T-helper epitope of the E7 transforming protein of human papillomavirus 16 provides cognate help for several E7 B-cell epitopes from cervical cancer-associated human papillomavirus genotypes . Proc Natl Acad Sci USA . 1991;88:5887–5891
- Cell-mediated immunological responses in cervical and vaginal cancer patients immunized with a lipidated epitope of human papillomavirus type 16 E7 . Clin Cancer Res . 1998;4:2103–2109
- . Definition of immunogenic determinants of the human papillomavirus type 16 nucleoprotein E7 . Eur J Cancer . 1992;28:326–333
- . Lymphoproliferative responses to human papillomavirus (HPV) type 16 proteins E6 and E7: outcome of HPV infection and associated neoplasia . J Natl Cancer Inst . 1997;89:1285–1293
- . Induction of cytotoxic T lymphocytes with peptides in vitro: identification of candidate T-cell epitopes in human papilloma virus . Proc Natl Acad Sci USA . 1992;89:7871–7875
- Vaccination with cytotoxic T lymphocyte epitope-containing peptide protects against a tumor induced by human papillomavirus type 16-transformed cells . Eur J Immunol . 1993;23:2242–2249
- . T cell epitopes in human papilloma virus proteins . Behring Inst Mitt . 1994;87–93
- Immune response to human papillomavirus type 16 E6 gene in a live vaccinia vector . J Gen Virol . 1994;75:157–164
- . Identification of H-2Kb binding and immunogenic peptides from human papilloma virus tumour antigens E6 and E7 . Scand J Immunol . 1995;42:317–323
- . Human leukocyte antigen-A2.1 restricted candidate cytotoxic T lymphocyte epitopes of human papillomavirus type 16 E6 and E7 proteins identified by using the processing-defective human cell line T2 . J Immunother . 1993;14:115–120
- Role of HLA-A motifs in identification of potential CTL epitopes in human papilloma-virus type 16 E6 and E7 proteins . J Immunology . 1994;152:3904–3912
- . Human cytotoxic T lymphocytes stimulated by endogenously processed human papillomavirus type 11 E7 recognize a peptide containing a HLA-A2(A*0201) motif . Immunology . 1994;81:222–227
- Human CTL epitopes encoded by human papillomavirus type 16 E6 and E7 identified through in vivo and in vitro immunogenicity studies of HLA-A*0201-binding peptides . J Immunol . 1995;154:5934–5943
- A recombinant vaccinia virus encoding human papillomavirus types 16 and 18, E6 and E7 proteins as immunotherapy for cervical cancer . Lancet . 1996;347:1523–1527
- Occasional memory cytotoxic T-cell responses of patients with human papilloma-virus type 16-positive cervical lesions against a human leukocyte antigen-A *0201-restricted E7-encoded epitope . Cancer Res . 1996;56:582–588
- HLA-A2-restricted peripheral blood cytolytic T lymphocyte response to HPV type 16 proteins E6 and E7 from patients with neoplastic cervical lesions . Cancer Immunol Immunother . 1996;42:151–160
- Cytotoxic T lymphocyte responses to E6 and E7 proteins of human papillomavirus type 16: relationship to cervical intraepithelial neoplasia . J Infect Dis . 1997;175:927–931
- . Infiltration of cervical cancer tissue with human papillomavirus-specific cytotoxic T-lymphocytes . Cancer Res . 1997;57:2943–2950
- . Lymphoproliferative response to fusion proteins of human papillomaviruses in patients with cervical intraepithelial neoplasia . Epidemiol Infect . 1989;103:625–632
- . Lymphoproliferative responses to human papillomaviruses in patients with cutaneous warts . Br J Dermatol . 1992;127:551–559
- . Human T cell responses to human papillomavirus type 16 L1 and E6 synthetic peptides: identification of T cell determinants, HLA-DR restriction and virus type specificity . J Gen Virol . 1990;71:423–431
- . Production and characterization of human proliferative T-cell clones specific for human papillomavirus type 1 E4 protein . J Virol . 1993;67:2799–2806
- Cell-mediated immune responses to E7 peptides of human papillomavirus (HPV) type 16 are dependent on the HPV type infecting the cervix whereas serological reactivity is not type-specific . J Gen Virol . 1994;75:2277–2284
- T cell proliferative responses against human papillomavirus type 16 E7 oncoprotein are most prominent in cervical intraepithelial neoplasia with a persistent viral infection . J Gen Virol . 1996;77:2183–2191
- . Proliferative T cell responses to human papillomavirus type 16 L1 peptides in patients with cervical dysplasia . J Gen Virol . 1996;77:593–602
- . T cell responses to the human papillomavirus type 16 E7 protein in mice of different haplotypes . J Gen Virol . 1992;73:1269–1274
- . Treatment of established renal cancer by tumor cells engineered to secrete interleukin-4 . Science . 1991;254:713–716
- . Human CD4+ T cells specifically recognize a shared melanoma-associated antigen encoded by the tyrosine gene . Proc Natl Acad Sci USA . 1994;91:9461–9465
- . Melanoma-specific CD4+ T lymphocytes recognize human melanoma antigens processed and presented by Epstein-Barr virus-transformed B cells . Int J Cancer . 1994;58:69–79
- . Rejection of mouse sarcoma cells after transfection of MHC class II genes . J Immunol . 1990;144:4068–4071
- . The effect of class II gene transfection on the tumorigenicity of the H-2K-negative mouse leukaemia cell line K36.16 . Immunology . 1991;72:213–218
- . Rejection of K1735 murine melanoma in syngeneic hosts requires expression of MHC class I antigens and either class II antigens or IL-2 . J Immunol . 1993;151:244–255
- . Follicular dendritic cells as accessory cells . Immunol Rev . 1990;117:111–185
- . T and B memory cells . Cell . 1994;76:315–322
- Risk factors associated with cervical human papillomavirus infections: a case-control study . Am J Epidemiol . 1993;138:735–745
- . The association of smoking and risk of condyloma acuminatum in women . Obstet Gynecol . 1997;89:346–350
- . Molecular characterization of defective antigen processing in human prostate cancer . J Natl Cancer Inst . 1995;87:280–285
- . Selectively down-regulated expression of major histocompatibility complex class I alleles in human solid tumors . Cancer Res . 1993;53:2416–2420
- Alterations of HLA class I and II antigen expression in preinvasive, invasive and metastatic cervical cancers . Exp Mol Med . 2001;33:136–144
- A mutation determining the loss of HLA-A2 antigen expression in a cervical carcinoma reveals novel splicing of human MHC class I classical transcripts in both tumoral and normal cells . Immunogenetics . 2000;51:1047–1052
- . Multiple genetic alterations cause frequent and heterogeneous human histocompatibility leukocyte antigen class I loss in cervical cancer . J Exp Med . 2000;191:961–976
- . Human leukocyte antigen class I gene mutations in cervical cancer . J Natl Cancer Inst . 1999;91:1669–1677
- . Loss of MHC class-I expression in cervical carcinomas . Int J Cancer . 1990;46:1029–1034
- Loss of transporter protein, encoded by the TAP-1 gene, is highly correlated with loss of HLA expression in cervical carcinomas . J Exp Med . 1994;179:335–340
- Analysis of MHC Class I and II expression in relation to presence of HPV genotypes in premalignant and malignant cervical lesions . Br J Cancer . 1993;67:1372–1980
- Human papillomavirus is a necessary cause of invasive cervical cancer worldwide . J Pathol . 1999;189:12–19
- . Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students . Am J Epidemiol . 2003;157:218–226
- . Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection . CMAJ . 2001;164:1017–1025
- . Vaccination against human papillomavirus infection: a new paradigm in cervical cancer control . Vaccine . 2005;23:2388–2394
- Epidemiologic classification of human papillomavirus types associated with cervical cancer . N Engl J Med . 2003;348:518–527
- HPV presence precedes abnormal cytology in women developing cervical cancer and signals false negative smears . Br J Cancer . 2001;85:398–404
- Characterization of DNA vaccines encoding the domains of calreticulin for their ability to elicit tumor-specific immunity and antiangiogenesis . Vaccine . 2005;23:3864–3874
- . Repeated DNA vaccinations elicited qualitatively different cytotoxic T lymphocytes and improved protective antitumor effects . J Biomed Sci . 2002;9:675–687
- . Tumor-specific immunity and antiangiogenesis generated by a DNA vaccine encoding calreticulin linked to a tumor antigen . J Clin Invest . 2001;108:669–678
- . Human papillomavirus and cancer: the epidemiological evidence . J Clin Virol . 2000;19:1–5
- . A comprehensive natural history model of HPV infection and cervical cancer to estimate the clinical impact of a prophylactic HPV-16/18 vaccine . Int J Cancer . 2003;106:896–904
- . Evaluating the role of human papillomavirus vaccine in cervical cancer prevention . Stat Methods Med Res . 2004;13:139–155
- A phase I trial of a human papillomavirus (HPV) peptide vaccine for women with high-grade cervical and vulvar intraepithelial neoplasia who are HPV 16 positive . Clin Cancer Res . 2000;6:3406–3416
- A phase I study to evaluate a human papillomavirus (HPV) type 18 L1 VLP vaccine . Vaccine . 2004;22:3004–3007
- Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial . Lancet . 2004;364:1757–1765
- Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial . Lancet Oncol . 2005;6:271–278
- A controlled trial of a human papillomavirus type 16 vaccine . N Engl J Med . 2002;347:1645–1651
- A Phase 1 study of a recombinant virus-like particle vaccine against human papillomavirus type 11 in healthy adult volunteers . J Infect Dis . 2001;183:1485–1493
- Priming of human papillomavirus type 11-specific humoral and cellular immune responses in college-aged women with a virus-like particle vaccine . J Virol . 2002;76:7832–7842
- Cellular immune responses to human papillomavirus (HPV)-16 L1 in healthy volunteers immunized with recombinant HPV-16 L1 virus-like particles . J Infect Dis . 2003;188:327–338
- Chimeric papillomavirus-like particles . Virology . 1997;234:93–111
- Chimeric papillomavirus virus-like particles elicit antitumor immunity against the E7 oncoprotein in an HPV16 tumor model . Proc Natl Acad Sci USA . 1998;95:1800–1805
- . The expressed L1 proteins of HPV-1, HPV-6, and HPV-11 display type-specific epitopes with native conformation and reactivity with neutralizing and nonneutralizing antibodies . Pathobiology . 1994;62:165–171
- . Immunological cross-reactivity to laboratory-produced HPV-11 virions of polysera raised against bacterially derived fusion proteins and synthetic peptides of HPV- 6b and HPV-16 capsid proteins . Virology . 1990;175:1–9
- . Minor capsid protein of human genital papillomaviruses contains subdominant, cross-neutralizing epitopes . Virology . 2000;270:254–257
- . Nasal immunization of mice with human papillomavirus type 16 (HPV-16) virus-like particles or with the HPV-16 L1 gene elicits specific cytotoxic T lymphocytes in vaginal draining lymph nodes . J Virol . 1999;73:9063–9071
- . Rapid induction of cytotoxic T-cell response against cervical cancer cells by human papillomavirus type 16 E6 antigen gene delivery into human dendritic cells by an adeno-associated virus vector . Cancer Gene Ther . 2001;8:948–957
- . Improving vaccine potency through intercellular spreading and enhanced MHC class I presentation of antigen . J Immunol . 2001;166:5733–5740
- . Enhancing major histocompatibility complex class I antigen presentation by targeting antigen to centrosomes . Cancer Res . 2003;63:2393–2398
- . Cancer immunotherapy using a DNA vaccine encoding the translocation domain of a bacterial toxin linked to a tumor antigen . Cancer Res . 2001;61:3698–3703
- . Enhancement of DNA vaccine potency by linkage of antigen gene to a gene encoding the extracellular domain of Fms-like tyrosine kinase 3-ligand . Cancer Res . 2001;61:1080–1088
- CD8+ T cells, NK cells and IFN-gamma are important for control of tumor with down-regulated MHC class I expression by DNA vaccination . Gene Ther . 2003;10:1311–1320
- Enhancement of human papillomavirus (HPV) type 16 E6 and E7-specific T-cell immunity in healthy volunteers through vaccination with TA-CIN, an HPV16 L2E7E6 fusion protein vaccine . Vaccine . 2002;20:3456–3464
- Phase I/II trial of immunogenicity of a human papillomavirus (HPV) type 16 E7 protein-based vaccine in women with oncogenic HPV-positive cervical intraepithelial neoplasia . Cancer Immunol Immunother . 2004;53:642–650
- Dendritic cell-based tumor vaccine for cervical cancer II: results of a clinical pilot study in 15 individual patients . J Cancer Res Clin Oncol . 2003;129:521–530
- Safety and immunogenicity of a peptide containing the cross-neutralization epitope of HPV16 L2 administered nasally in healthy volunteers . Vaccine . 2003;21:4256–4260
PII: S1028-4559(09)60145-5
doi:10.1016/S1028-4559(09)60145-5
© 2005 Taiwan Association of Obstetric & Gynecology. Published by Elsevier Inc. All rights reserved.
Volume 44, Issue 3 , Pages 232-241, September 2005
