More Questions on Cervical Cancer Vaccine
Posted by Jacob Goldstein
May 9, 2007, 5:18 pm
Today’s New England Journal of Medicine lands with no fewer than three studies, two essays and two editorials on HPV, the virus that causes cervical cancer, and Gardasil, Merck’s vaccine against the virus. Fortunately, this editorial by the journal’s editors hits the high points and raises the key questions.
media.nejm.org
One study they highlight suggests HPV infection is correlated with head and neck cancer. Another showed the vaccine worked very well in reducing precancerous lesions in women who were vaccinated before infection — but far less well in women who had already been exposed to the virus, as this WSJ story explains. [NEXT]
The editors list many questions that remain unanswered. Should boys or young men get the vaccine? How long does the protection conferred by the vaccine last? Could the current recommendation of three vaccinations be lowered? Could the HPV vaccine help prevent some cancers of the head and neck?
“There is no doubt that the findings reported in this issue of the Journal open a new field at the interface of basic science, clinical medicine, public health, and public policy,” the editors write without undue modesty. “We have begun an exciting journey; we need to continue in the right direction.”
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All great questions, well designed clinical studies and post-treatment follow-up over the long term can help answer many of these.
The true promise of the vaccine seems larger than its initial focus, just like the first discovery of an natural antibiotic has lead to better outcomes for global human health.
As a ex-cancer research scientist who tried to keep normal cells alive in cell culture by using specific HPV genes, it is ironic that this vaccine can turn that approach on its head and help prevent cancers caused by HPV?
Comment by anonymous - May 9, 2007 at 5:49 pm
A thoroughly useless editorial in the NEJM by the individuals from UCSF; we need a “cautious approach.” That really gives me a wonderful response to patients; what exactly is a cautious approach? Do we immunize? Don’t we immunize? When? Under what circumstances? How long do we wait? Wow, I’m just overwhelmed with good, meaningful information.
Comment by Bill - May 9, 2007 at 6:35 pm
Thanks for sharing this editorial, and I am thrilled that additional complications of HPV infection are finally being addressed. My co-author and I in the book “Avoiding Cancer One Day At A Time” cite credible studies that HPV is probably responsible for 25 percent of oral cancers in the United States. These cancers tend to have a better prognosis, but also tend to occur in young people. With all of the media attention over the vaccine, I have been shocked that this significant issue has been entirely neglected. Thanks for raising awareness!
Comment by Lynne Eldridge M.D. - May 10, 2007 at 1:23 am
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