• Therapeutic vaccines aim to induce or boost HPV T-cell adaptive immunity when it is insufficient or has failed to develop naturally.
• The high-risk HPV type oncogenes E6 and E7 are obligate for driving the malignant process in cervical neoplasia and are the preferred targets.
• Vaccines based on viral protein or peptides together with adjuvants which act to stimulate the desired balance of T-cell response, or naked DNA, viral, or bacterial vectors encoding the viral targets have been tested in preclinical animal models.
• Early phase clinical trials of therapeutic vaccines in cervical cancer patients have shown evidence of immunogenicity and safety, but clinical efficacy has not been established. In part, this is because of the complexity of immunological escape mechanisms which the tumour has utilized during its evolution.
• Trials aimed at treating HPV-persistent infection in recalcitrant VIN 3 are a useful proving ground for testing combined treatment modalities that include vaccination to focus the cellular immunity away from negative influences of T regulatory cells.
This practical online reference provides an overview of the role of HPV in the pathology of cervical cancer and its current screening and management, the principles of immune control of HPV infection in cervical cancer, and the challenges of implementing HPV vaccines and future developments.
Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
