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Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To determine whether quadrivalent HPV vaccination is effective in reducing recurrent disease in women with a previous history of HPV disease.

Methods

All women under 45 years of age treated for HPV-linked disease and with negative HPV test, cytology and colposcopy 3 months after treatment were enrolled. Women were randomly assigned into two groups: a group that received HPV vaccine post treatment and a group that was only submitted to follow-up. Follow-up was performed every 6 months for a duration of at least 3 years. Kaplan–Meier curve was used to estimate the overall disease-free survival during the follow-up period. Statistical analysis was performed by Fisher’s exact test.

Results

From November 2013 to October 2014, we enrolled a total of 178 women at Careggi University Hospital in Florence and at Azienda USL in Massa Carrara. 12 out of 89 patients in the non-vaccination group recurred (13.5%), while 3 out of 89 patients in the vaccination group recurred (3.4%). The Kaplan–Meier curves showed a statistically difference in the log rank test (p = 0.0147) for the overall disease-free survival in the study groups during follow-up. The rate of recurrence was significantly higher in the non-vaccination group, with a p = 0.0279 by Fisher exact test.

Conclusion

The introduction of anti-HPV vaccination during the follow-up post treatment for HPV-linked disease is recommended to reduce the risk of recurrence. The clinical implication of this could be very important to influence post-treatment management of HPV disease.

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References

  1. Walboomers JM, Jacobs MV, Manos MM et al (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189:12–19

    Article  CAS  Google Scholar 

  2. Li N, Franceschi S, Howell-Jones R et al (2010) Human papillomavirus type distribution in 30,848 invasive cervical cancer world wide: variation by geographical region, histological type and year of publication. Int J Cancer 128:927–935

    Article  Google Scholar 

  3. Kim DK, Riley LE, Harriman KH et al (2017) Raccomended immunization schedule for adults aged 19 years or older, United States, 2017. Ann Intern Med 166:209

    Article  Google Scholar 

  4. Markowitz LE, Dunne EF, Saraiya M et al (2014) Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 63:1

    PubMed  Google Scholar 

  5. Petrosky E, Bocchini JA Jr, Hariri S et al (2015) Use of 9-valent human papilloma virus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep 64:300

    PubMed  PubMed Central  Google Scholar 

  6. Robinson CL, Romero JR, Kempe A et al (2017) Advisory Committee on Immunization Practices recommended immunization schedule for children adolescents aged 18 years or younger—United States, 2017. MMWR Morb Mortal Wkly Rep 66:134

    Article  Google Scholar 

  7. Ault KA, Future II Study Group (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  Google Scholar 

  8. Sangar VC, Ghongane B, Mathur G (2016) Development of human papillomavirus (HPV) vaccines: a review of literature and clinical update. Rev Recent Clin Trials 11:284–289

    Article  CAS  Google Scholar 

  9. Joura EA, Garland SM, Paavonen J, FUTURE I and II Study Group et al (2012) Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data. BMJ 344:e1401

    Article  Google Scholar 

  10. Kang WD, Choi HS, Kim SM (2013) Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2-3)? Gynecol Oncol 130(2):264–268

    Article  CAS  Google Scholar 

  11. Garland SM, Paavonen J, Jaisamrarn U, HPV PATRICIA Study Group et al (2016) Prior human papillomavirus-16/18 AS04-adjuvanted vaccination prevents recurrent high-grade cervical intraepithelial neoplasia after definitive surgical therapy: Post-hoc analysis from a randomized controlled trial. Int J Cancer 139(12):2812–2826

    Article  CAS  Google Scholar 

  12. Brotherton JML, Wrede CDH (2014) Offering HPV vaccination to women treated for high-grade cervical intra-epithelial neoplasia: what do you need to know? Aust NZ J Obstet Gynaecol 54(4):393–394

    Article  Google Scholar 

  13. Szarewski A, Poppe WA, Skinner SR et al (2012) Efficacy of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in women aged 15–25 years with and without serological evidence of previous exposure to HPV-16/18. Int J Cancer 131:106–116

    Article  CAS  Google Scholar 

  14. Olsson SE, Kjaer SK, Sigurdsson K et al (2009) Evaluation of quadrivalent HPV 6/11/16/18 vaccine efficacy against cervical and anogenital disease in subjects with serological evidence of prior vaccine type HPV infection. Hum Vaccin 5:696–704

    Article  CAS  Google Scholar 

  15. Bais AG, Eijkemans MJ, Rebolj M et al (2009) Post-treatment CIN: randomised clinical trial using hrHPV testing for prediction of residual/recurrent disease. Int J Cancer 124(4):889–895

    Article  CAS  Google Scholar 

  16. Kocken M, Uijterwaal MH, de Vries AL et al (2012) High-risk human papillomavirus testing versus cytology in predicting post-treatment disease in women treated for high-grade cervical disease: a systematic review and meta-analysis. Gynaecol Oncol 125(2):500–507

    Article  Google Scholar 

  17. Kreimer AR, Guido RS, Solomon D et al (2006) Human papillomavirus testing following loop electrosurgical excision procedure identifies women at risk for post-treatment cervical intraepithelial neoplasia grade 2 or 3 disease. Cancer Epidemiol Biomark Prev 15(5):908–911

    Article  Google Scholar 

  18. Lörincz AT (2003) Screening for cervical cancer: new alternatives and research. Salud Publica Mex 45(Suppl 3):S376–S387

    Article  Google Scholar 

  19. Pieralli A, Corioni S, Bianchi C et al. Feasibility of Quadrivalent HPV Vaccination as Immunologic Booster to Prevent Relapses In an Italian Cohort of Women Treated for Cervical Intraepithelial Neoplasia (CIN). MOJ Womens Health 2(4): 00040. https://doi.org/10.15406/mojwh.2016.02.00040

  20. Carvalho N, Teixeira J, Roteli-Martins CM et al (2010) Sustained efficacy and immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine up to 7.3 years in young adult women. Vaccine 28(38):6247–6255

    Article  Google Scholar 

  21. Garland SM, Hernandez-Avila M, Wheeler CM et al (2007) Quadrivalent vaccine against human papillomavirus to prevent ano-genital diseases. N Engl J Med 356(19):1928–1943

    Article  CAS  Google Scholar 

  22. Castellsagué X, Muñoz N, Pitisuttithum P et al (2011) End-of-study safety, immunogenicity, and efficacy of quadrivalent HPV (types 6, 11, 16, 18) recombinant vaccine in adult women 24–45 years of age. Br J Cancer 105(1):28–37

    Article  Google Scholar 

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Funding

This was funded by research grants of Fondazione Cassa di Risparmio di Florence

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Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Annalisa Pieralli, Claudia Bianchi, Noemi Auzzi, Maria Grazia Fallani, Cecilia Bussani, Massimiliano Fambrini, Giuseppe Cariti, Gianfranco Scarselli & Felice Petraglia

  2. Azienda USL-1 Massa e Carrara, Via Minzoni Don Giovanni 3, 54033, Carrara, MS, Italy

    Alessandro Ghelardi

Authors
  1. Annalisa Pieralli
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  2. Claudia Bianchi
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  3. Noemi Auzzi
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  4. Maria Grazia Fallani
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  5. Cecilia Bussani
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  6. Massimiliano Fambrini
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  7. Giuseppe Cariti
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  8. Gianfranco Scarselli
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  9. Felice Petraglia
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  10. Alessandro Ghelardi
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Contributions

Protocol/project development: AP, AG, MF. Conceptualization: AP. Funding acquisition: CB, MF. Data collection and management: CB, NA. Blind colposcopists and physicians: AP, AG, MGF. Blind biologists: CB. Data Analysis: CB, NZ. Manuscript writing/editing: CB, NA, GC, FP. Supervision: GC, FP.

Corresponding author

Correspondence to Claudia Bianchi.

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We declare that we have no conflict of interest.

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Pieralli, A., Bianchi, C., Auzzi, N. et al. Indication of prophylactic vaccines as a tool for secondary prevention in HPV-linked disease. Arch Gynecol Obstet 298, 1205–1210 (2018). https://doi.org/10.1007/s00404-018-4926-y

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  • DOI: https://doi.org/10.1007/s00404-018-4926-y

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