Skip to main content
Log in

Nobelpreis für die Impfung gegen Zervixkrebs

Aktuelle Daten- und Leitlinienlage

Nobel price for vaccination against cervical cancer: Current data and guidelines

  • Arzneimitteltherapie
  • Published:
Der Internist Aims and scope Submit manuscript

Zusammenfassung

Harald zur Hausen erhielt 2008 den Nobelpreis für Medizin für seine grundlegenden Arbeiten zu humanen Papillomaviren (HPV) und ihrer Assoziation mit anogenitalen Erkrankungen. Auf Basis seiner Arbeiten wurden hochwirksame prophylaktische HPV-Impfstoffe entwickelt. Klinische Studien zeigten fast 100% Serokonversion und hervorragende Sicherheitsdaten sowie eine über 96%ige Wirksamkeit gegen persistierende Infektionen und prämaligne Dysplasien, die durch HPV-Typen hervorgerufen werden, die vom Impfstoff abgedeckt werden. Aufgrund der überzeugenden Studiendatenlage der Phase-II- und -III-Studien wurde die Einführung der Impfung durch Zulassungsbehörden und sachkundige Gremien empfohlen. Die Formulierung und Verfügbarkeit hochgradiger Leitlinien und evidenzbasierter Empfehlungen sollte die Einführung der Vakzine und flächendeckende Impfung unterstützen.

Abstract

Harald zur Hausen received the Nobel price for Medicine in 2008 for his seminal research on human papilloma viruses and their association with anogenital diseases. On the basis of his work highly effective prophylactic vaccines have been developed. Clinical studies have shown nearly 100% seroconversion and an excellent safety profile as well as greater than 96% efficacy against HPV infection and premalignant dysplasia, induced by HPV types covered by the vaccine. Due to the convincing data of phase II and III clinical trials the introduction of HPV vaccination was recommended by health authorities and scientific committees in Germany. The development and availability of guidelines and evidence-based recommendations should support the introduction of the vaccine and widespread vaccination.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Ault KA (2007) Effect of prophylactic human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3 and adenocarcinoma in situ: a combined analysis of four randomised clinical trials. Lancet 369: 1861–1868

    Article  PubMed  CAS  Google Scholar 

  2. Booy FP, Roden RB, Greenstone HL et al. (1998) Two antibodies that neutralize papillomavirus by different mechanisms show distinct binding patterns at 13 A resolution. J Mol Biol 281: 95–106

    Article  PubMed  CAS  Google Scholar 

  3. Boshart M, Gissmann L, Ikenberg H et al. (1984) A new type of papillomavirus DNA, its presence in genital cancer biopsies and in cell lines derived from cervical cancer. EMBO J 3: 1151–1157

    PubMed  CAS  Google Scholar 

  4. David MP, Van Herck K, Hardt K et al. (2009) Long-term persistence of anti-HPV-16 and -18 antibodies induced by vaccination with the AS04-adjuvanted cervical cancer vaccine: Modeling of sustained antibody responses. Gynecol Oncol [Epub ahead of print]

  5. Durst M, Gissmann L, Ikenberg H, Zur Hausen H (1983) A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions. Proc Natl Acad Sci U S A 80: 3812–3815

    Article  PubMed  CAS  Google Scholar 

  6. FUTURE II (2007) Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med 356: 1915–1927

    Article  Google Scholar 

  7. Garland SM, Hernandez-Avila M, Wheeler CM et al. (2007) Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 356: 1928–1943

    Article  PubMed  CAS  Google Scholar 

  8. Garland SM, Steben M, Hernandez-Avila M et al. (2007) Noninferiority of antibody response to human papillomavirus type 16 in subjects vaccinated with monovalent and quadrivalent L1 virus-like particle vaccines. Clin Vaccine Immunol 14: 792–795

    Article  PubMed  CAS  Google Scholar 

  9. Giannini SL, Hanon E, Moris P et al. (2006) Enhanced humoral and memory B cellular immunity using HPV16/18 L1 VLP vaccine formulated with the MPL/aluminium salt combination (AS04) compared to aluminium salt only. Vaccine 24: 5937–5949

    Article  PubMed  CAS  Google Scholar 

  10. Harper DM, Franco EL, Wheeler C et al. (2004) 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 364: 1757–1765

    Article  PubMed  CAS  Google Scholar 

  11. Harper DM, Franco EL, Wheeler CM et al. (2006) Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 367: 1247–1255

    Article  PubMed  CAS  Google Scholar 

  12. Joura EA, Leodolter S, Hernandez-Avila M et al. (2007) Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials. Lancet 369: 1693–1702

    Article  PubMed  CAS  Google Scholar 

  13. Khan MJ, Castle PE, Lorincz AT et al. (2005) The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst 97: 1072–1079

    Article  PubMed  Google Scholar 

  14. Kirnbauer R, Booy F, Cheng N et al. (1992) Papillomavirus L1 major capsid protein self-assembles into virus-like particles that are highly immunogenic. Proc Natl Acad Sci U S A 89: 12180–12184

    Article  PubMed  CAS  Google Scholar 

  15. Koutsky L (1997) Epidemiology of genital human papillomavirus infection. Am J Med 102: 3–8

    Article  PubMed  CAS  Google Scholar 

  16. Luther-Übersetzung (1545) Die Bibel, 5. Buch Mose. Kap. 28, Vers 27

  17. McCredie MR, Sharples KJ, Paul C et al. (2008) Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol 9: 425–434

    Article  PubMed  Google Scholar 

  18. Paavonen J, Jenkins D, Bosch FX et al. (2007) Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet 369: 2161–2170

    Article  PubMed  CAS  Google Scholar 

  19. Pathirana D, für das HPV Management Forum (2008) S3-Leitlinie zur Impfprävention HPV-assoziierter Neoplasien. J Chemother 17: 120–171

    Google Scholar 

  20. Reisinger KS, Block SL, Lazcano-Ponce E et al. (2007) Safety and persistent immunogenicity of a quadrivalent human papillomavirus types 6, 11, 16, 18 L1 virus-like particle vaccine in preadolescents and adolescents: a randomized controlled trial. Pediatr Infect Dis J 26: 201–209

    Article  PubMed  Google Scholar 

  21. Robert Koch-Institut (2007) Mittteilung der Ständigen Impfkommission (STIKO) am Robert-Koch-Institut. Impfung gegen humane Papillomaviren (HPV) für Mädchen von 12 bis 17 Jahren – Empfehlung und Begründung. Epidemiol Bull 12: 97–103

    Google Scholar 

  22. Schiller JT, Castellsague X, Villa LL, Hildesheim A (2008) An update of prophylactic human papillomavirus L1 virus-like particle vaccine clinical trial results. Vaccine 26 (Suppl): K53–K61

    Article  PubMed  CAS  Google Scholar 

  23. Schreckenberger C, Kaufmann AM, Schneider A (2007) Implementation of HPV vaccination in Germany. Dtsch Med Wochenschr 132: 2221–2224

    Article  PubMed  CAS  Google Scholar 

  24. Siegrist CA, Lewis EM, Eskola J et al. (2007) Human papilloma virus immunization in adolescent and young adults: a cohort study to illustrate what events might be mistaken for adverse reactions. Pediatr Infect Dis J 26: 979–984

    Article  PubMed  Google Scholar 

  25. Smith JF, Brownlow M, Brown M et al. (2007) Antibodies from women immunized with Gardasil cross-neutralize HPV 45 pseudovirions. Hum Vaccin 3: 109–115

    PubMed  CAS  Google Scholar 

  26. Villa LL, Ault KA, Giuliano AR et al. (2006) Immunologic responses following administration of a vaccine targeting human papillomavirus Types 6, 11, 16, and 18. Vaccine 24: 5571–5583

    Article  PubMed  CAS  Google Scholar 

  27. Villa LL, Costa RL, Petta CA et al. (2006) High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer 95: 1459–1466

    Article  PubMed  CAS  Google Scholar 

  28. Vonka V, Kanka J, Hirsch I et al. (1984) Prospective study on the relationship between cervical neoplasia and herpes simplex type-2 virus. II. Herpes simplex type-2 antibody presence in sera taken at enrolment. Int J Cancer 33: 61–66

    Article  PubMed  CAS  Google Scholar 

  29. Vonka V, Kanka J, Jelinek J et al. (1984) Prospective study on the relationship between cervical neoplasia and herpes simplex type-2 virus. I. Epidemiological characteristics. Int J Cancer 33: 49–60

    Article  PubMed  CAS  Google Scholar 

  30. Wheeler CM, Bautista OM, Tomassini JE et al. (2008) Safety and immunogenicity of co-administered quadrivalent human papillomavirus (HPV)-6/11/16/18 L1 virus-like particle (VLP) and hepatitis B (HBV) vaccines. Vaccine 26: 686–696

    Article  PubMed  CAS  Google Scholar 

  31. Zur Hausen H (1976) Condylomata acuminata and human genital cancer. Cancer Res 36: 794

    Google Scholar 

  32. Zur Hausen H (2002) Papillomaviruses and cancer: from basic studies to clinical application. Nat Rev Cancer 2: 342–350

    Article  CAS  Google Scholar 

  33. Zur Hausen H (2009) Papillomaviruses in the causation of human cancers – a brief historical account. Virology 384: 260–265

    Article  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin:

Honorare für Beratungs- und Referententätigkeit von GSK, SPMSD, Grenprobe.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A.M. Kaufmann.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hepburn, H., Kaufmann, A. Nobelpreis für die Impfung gegen Zervixkrebs. Internist 50, 617–626 (2009). https://doi.org/10.1007/s00108-009-2388-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00108-009-2388-9

Schlüsselwörter

Keywords

Navigation