Skip to main content
Log in

Human Papillomavirus Quadrivalent (types 6, 11, 16, 18) Recombinant Vaccine (Gardasil®)

  • Adis Drug Profile
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

  • ▴ Human papillomavirus (HPV) quadrivalent recombinant vaccine is a mixture of virus-like particles derived from the L1 capsid proteins of HPV types 6, 11, 16 and 18. It is administered intramuscularly in a three-dose regimen, with the initial injection followed by subsequent doses at months 2 and 6. The vaccine is indicated for use in the prevention of cervical cancer, vulvar and vaginal precancer and cancers, precancerous lesions and genital warts associated with HPV types 6, 11, 16 or 18 infection in adolescents and young women.

  • ▴ The quadrivalent vaccine has demonstrated good immunogenicity in young women (16–26 years) and male and female adolescents (aged 9–15 years), inducing high and persistent anti-HPV antibody titres. In a randomised phase III trial designed to bridge efficacy in young women to adolescents (using immunogenicity as a surrogate), the quadrivalent HPV vaccine in adolescents was at least as immunogenic as that in young women.

  • ▴ In randomised, double-blind, placebo-controlled trials in >20 000 young women (aged 16–26 years), the vaccine was highly effective in preventing cervical dysplasia of any grade and external genital lesions related to HPV types 6, 11, 16 and 18 infection. These women were followed up for an average of 2 years.

  • ▴ The vaccine was well tolerated, with injection-site reactions and fever being the most common vaccine-related adverse events.

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.

Fig. 1

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Ferlay J, Bray F, Pisani P, et al. GLOBOCAN 2002: cancer incidence, mortality and prevalence. Worldwide IARC CancerBase no. 5. version 2.0. Lyon: IARC Press, 2004

    Google Scholar 

  2. National Cancer Institute. Cervical cancer physician data query (PDQ®): screening (health professional version) [online]. Available from URL: http://cancer.gov/ [Accessed 2006 Apr 5]

  3. Sirovich BE, Welch HG. The frequency of Pap smear screening in the United States. J Gen Intern Med 2004 Mar; 19(3): 243–50

    Article  PubMed  Google Scholar 

  4. National Cancer Institute. Cervical cancer physician data query (PDQ®): prevention (health professional version) [online]. Available from URL: http://cancer.gov/ [Accessed 2006 Apr 5]

  5. American Cancer Society. Cancer facts & figures 2006 [online]. Available from URL: http://www.cancer.org/ [Accessed 2006 Apr 5]

  6. Bosch FX, de Sanjose S. Chapter 1: human papillomavirus and cervical cancer-burden and assessment of causality. J Natl Cancer Inst Monogr 2003; 31: 3–13

    Article  PubMed  Google Scholar 

  7. The National Center for HIV, STD, andTB Prevention. Genital HPV infection [online]. Available from URL: http://www.cdc.gov/ [Accessed 2006 Apr 5]

  8. Franco EL, Harper DM. Vaccination against human papillomavirus infection: a new paradigm in cervical cancer control. Vaccine 2005 Mar 18; 23(17–18): 2388–94

    Article  PubMed  CAS  Google Scholar 

  9. Jansen KU, Shaw AR. Human papillomavirus vaccines and prevention of cervical cancer. Annu Rev Med 2004; 55: 319–31

    Article  PubMed  CAS  Google Scholar 

  10. Clifford GM, Rana RK, Franceschi S, et al. Human papillomavirus genotype distribution in low-grade cervical lesions: comparison by geographic region and with cervical cancer. Cancer Epidemiol Biomarkers Prev 2005 May; 14(5): 1157–64

    Article  PubMed  Google Scholar 

  11. Munoz N, Bosch FX, Castellsague X, et al. Against which human papillomavirus types shall we vaccinate and screen? The international perspective. Int J Cancer 2004 Aug 20; 111(2): 278–85

    Article  PubMed  CAS  Google Scholar 

  12. Villa LL, Costa RLR, Petta CA, et al. 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 May; 6(5): 271–8

    Article  PubMed  Google Scholar 

  13. Fife KH, Wheeler CM, Koutsky LA, et al. Dose-ranging studies of the safety and immunogenicity of human papillomavirus type 11 and type 16 virus-like particle candidate vaccines in young healthy women. Vaccine 2004 Jul 29; 22(21–22): 2943–52

    Article  PubMed  CAS  Google Scholar 

  14. Kulasingam SL, Myers ER. Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. JAMA 2003 Aug 13; 290(6): 781–9

    Article  PubMed  Google Scholar 

  15. Elbasha EH, Dasbach EJ, Insinga RP. Projecting the health and economic impact of a quadrivalent HPV vaccine using a multitype transmission dynamic model [abstract]. The 40th National Immunization Conference; 2006 Mar 6–9; Atlanta (GA)

  16. Tobery TW, Smith JF, Kuklin N, et al. Effect of vaccine delivery system on the induction of HPV16 L1-specific humoral and cell-mediated immune responses in immunized rhesus macaques. Vaccine 2003 Mar 28; 21(13–14): 1539–47

    Article  PubMed  CAS  Google Scholar 

  17. Ruiz W, McClements WL, Jansen KU, et al. Kinetics and isotype profile of antibody responses in rhesus macaques induced following vaccination with HPV 6, 11, 16 and 18 L1-virus-like particles formulated with or without Merck aluminum adjuvant. J Immune Based Ther Vaccines 2005 Apr 20; 3(1): 2–12

    Article  PubMed  Google Scholar 

  18. Koutsky LA, Ault KA, Wheeler CM, et al. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med 2002 Nov 21; 347: 1645–51

    Article  PubMed  CAS  Google Scholar 

  19. Poland GA, Jacobson RM, Koutsky LA, et al. Immunogenicity and reactogenicity of a novel vaccine for human papillomavirus 16: a 2-year randomized controlled clinical trial. Mayo Clin Proc 2005 May; 80(5): 601–10

    Article  PubMed  CAS  Google Scholar 

  20. Ault KA, Giuliano AR, Edwards RP, et al. A phase I study to evaluate a human papillomavirus (HPV) type 18 L1 VLP vaccine. Vaccine 2004 Aug 13; 22(23–24): 3004–7

    Article  PubMed  CAS  Google Scholar 

  21. Nolan T, Block SL, Reisinger KS, et al. Comparison of the immunogenicity and tolerability of a prophylactic quadrivalent human papillomavirus (HPV) (types 6, 11, 16, 18) L1 virus-like particle (VLP) vaccine in male and female adolescents and young adult women [abstract]. The 23rd Annual Meeting of the European Society of Paediatric Infectious Diseases; 2005 May 18–20; Valencia

  22. Reisinger KS, Block SL, Lazcano E, et al. A randomized controlled trial to evaluate the safety and immunogenicity of a quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in preadolescents and adolescents [abstract]. The 24th Annual Meeting of the European Society for Paediatric Infectious Diseases; 2006 May 3–5; Basel

  23. Villa LL, Costa RLR, Petta CA. Induction of immune memory following administration of a prophylactic quadrivalent Human Papillomavirus (HPV) types 6/11/16/18 LI virus-like particle (VLP) vaccine [abstract]. The 12th International Congress on Infectious Diseases; 2006 Jun 15–18; Lisbon

  24. Mao C, Koutsky LA, Ault KA, et al. Efficacy of human papillomavirus-16 vaccine to prevent cervical intraepithelial neoplasia: a randomized controlled trial. Obstet Gynecol 2006 Jan; 107(1): 18–27

    Article  PubMed  Google Scholar 

  25. Sattler C, Future 1 Investigators. Efficacy of a prophylactic quadrivalent human papillomavirus (types 6, 11, 16, 18) L1 virus-like particle vaccine for prevention of cervical dysplasia and external genital lesions [abstract no. LB2-25]. The 45th Interscience Conference on Antimicrobial Agents and Chemotherapy; 2005 Dec 16–19; Washington (DC)

  26. Skjeldestad FE, Future II Steering Committee. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, 18) L1 virus-like particle vaccine (Gardasil™) reduces cervical intraepithelial neoplasia 2/3 risk [abstract no. LB-8]. The 43rd Annual Meeting of the Infectious Diseases Society of America; 2005 Oct 6–9; San Francisco (CA)

  27. Villa LL, Costa RLR, Petta CA, et al. Efficacy of a prophylactic quadrivalent human papillomavirus (HPV) types 6/11/16/18 L1 virus-like particle (VLP) vaccine through up to 5 years of follow-up [abstract]. The 6th International Multidisciplinary Congress of the European Research Organization on Genital Infection and Neoplasia; 2006 Apr 23–26; Paris

  28. Ault K, on behalf of the Gardasil™ Phase III Steering Committee. Prophylactic use of quadrivalent human papillomavirus (types 6, 11, 16, 18) L1 virus-like particle vaccine reduces cervical intraepithelial neoplasia 2/3 and adenocarcinoma in situ risk [abstract no. PS10]. Eur J Can Suppl 2005; 3(4): 11. Plus oral presentation at the European Cancer Conference; 2005 Oct 30–Nov 3; Paris

    Article  Google Scholar 

  29. Paavonen J, for the FUTURE II Study Group. Efficacy of a quadrivalent HPV (types 6/11/16/18) L1 virus-like particle (VLP) vaccine against vaginal and vulvar pre-cancerous lesions: a combined analysis [abstract]. The 42nd Annual Meeting of the American Society for Clinical Oncology; 2006 Jun 2–6; Atlanta (GA)

  30. Ferris D, for the FUTURE II Study Group. Efficacy of a quadrivalent HPV (types 6/11/16/18) L1 virus-like particle (VLP) vaccine in women with virologic evidence of HPV infection: a combined analysis [abstract]. The 6th International Multidisciplinary Congress of the European Research Organization on Genital Infection and Neoplasia; 2006 Apr 23–26; Paris

  31. Olsson SE, for the FUTURE II Study Group. Post-infection prophylaxis of a quadrivalent HPV (types 6, 11, 16, 18) L1 VLP vaccine: a combined analysis [abstract]. The 6th International Multidisciplinary Congress of the European Research Organization on Genital Infection and Neoplasia; 2006 Apr 23–26; Paris

  32. Merck & Co. Inc.. Product information (US): Gardasil® (quadrivalent human papillomavirus [types 6, 11, 16, 18] recombinant vaccine). Available from URL: http://www.fda.gov/cber/label/hpvmer060806LB.pdf [Accessed 2006 Jun 12]

  33. Merck & Co. Inc. Gardasil™, Merck’s investigational cervical cancer vaccine, produced high anti-HPV immune response in adolescents; newest data on Gardasil™ presented at European Society of Pediatric Infectious Diseases [media release]. 2005 May 19

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Asif A. Siddiqui.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siddiqui, M.A.A., Perry, C.M. Human Papillomavirus Quadrivalent (types 6, 11, 16, 18) Recombinant Vaccine (Gardasil®). Drugs 66, 1263–1271 (2006). https://doi.org/10.2165/00003495-200666090-00008

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200666090-00008

Keywords

Navigation