Prophylactic human papillomavirus vaccines.
Lowy DR, Schiller JT.
Laboratory of Cellular Oncology, Center for Cancer Research,
National Cancer Institute, NIH, Bethesda, Maryland 20892, USA.
drl@helix.nih.gov
Human papillomavirus (HPV) infection causes virtually all cases
of cervical cancer, the second most common cause of death from
cancer among women worldwide. This Review examines prophylactic
HPV subunit vaccines based on the ability of the viral L1 capsid
protein to form virus-like particles (VLPs) that induce high
levels of neutralizing antibodies. Following preclinical
research by laboratories in the nonprofit sector, Merck and
GlaxoSmithKline are developing commercial versions of the
vaccine. Both vaccines target HPV16 and HPV18, which account for
approximately 70% of cervical cancer. The Merck vaccine also
targets HPV6 and HPV11, which account for approximately 90% of
external genital warts. The vaccines have an excellent safety
profile, are highly immunogenic, and have conferred complete
type-specific protection against persistent infection and
associated lesions in fully vaccinated women. Unresolved issues
include the most critical groups to vaccinate and when the
vaccine's cost may be low enough for widespread implementation
in the developing world, where 80% of cervical cancer occurs.
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