1. Ten-year follow-up of human papillomavirus vaccine efficacy against the most stringent cervical neoplasia end-point—registry-based follow-up ofthree cohorts from randomized trials
- Author
-
Tiina Eriksson, Gary Dubin, Tapio Luostarinen, Joakim Dillner, Kari Natunen, Camilla Lagheden, Marjo Kuortti, Dan Apter, Eero Pukkala, Tiina Petäjä, Mari Siitari-Mattila, Frank Struyf, Katja Harjula, Jorma Paavonen, Johanna Palmroth, Pekka Nieminen, Matti Lehtinen, Clinicum, Department of Obstetrics and Gynecology, University of Helsinki, and HUS Gynecology and Obstetrics
- Subjects
medicine.medical_specialty ,IMPACT ,HEPATITIS-B ,CHILDREN ,HPV vaccines ,Cervical intraepithelial neoplasia ,03 medical and health sciences ,0302 clinical medicine ,HEPATOCELLULAR-CARCINOMA ,Internal medicine ,INFECTION ,medicine ,030212 general & internal medicine ,ENROLLMENT ,Cervical cancer ,Intraepithelial neoplasia ,business.industry ,YOUNG-WOMEN ,General Medicine ,medicine.disease ,Vaccine efficacy ,HPV-16/18 AS04-ADJUVANTED VACCINE ,female genital diseases and pregnancy complications ,3. Good health ,Cancer registry ,Vaccination ,INTRAEPITHELIAL NEOPLASIA ,3121 General medicine, internal medicine and other clinical medicine ,030220 oncology & carcinogenesis ,Cohort ,Immunology ,BLIND PATRICIA TRIAL ,business - Abstract
ObjectiveDue to long lag time between infection/cancer diagnoses human papillomavirus (HPV) vaccination programs will deliver vaccine efficacy (VE) estimates against cancer end-points late. Cancer registry follow-up of population-based, randomised trial cohorts of vaccinated and unvaccinated women was undertaken for the estimation of VE against cervical intraepithelial neoplasia grade three and invasive cancer (CIN3+).MethodsWe report interim results with 98 561 person years of Finnish Cancer Registry -based follow-up of individually and/or cluster randomised cohorts of HPV-16/18 vaccinated and unvaccinated adolescent women enrolled in June 2003/2005, and between May 2004 and April 2005, respectively. The cohorts comprised 15 627 18- to 19-year-old unvaccinated women (NCT01393470), and 2 401 and 64 16- to 17-year-old HPV-16/18 vaccinated women participating the PATRICIA (NCT00122681) and HPV-012 (NCT00169494) trials, respectively. The age-aligned passive follow-up started 6 months after the clinical trials’ end.ResultsDuring the follow-up of 4.5 to 10 years post enrolment we identified 75 cases of cervical intraepithelial neoplasia grade 3 (CIN3) and 4 cases of invasive cervical cancer (ICC) in the unvaccinated cohort, and 4 CIN3 cases in the HPV-16/18 vaccinated women. Diagnostic blocks were available for HPV typing from 87% of the cases. CIN3+ lesions were detectable in 54 cases. HPV16 was found in 26 of 50 unvaccinated CIN3+ cases, and in 3 CIN3+ cases in the HPV-16/18 vaccinated women. The latter were all baseline positive for cervical HPV16 DNA. Baseline data was not available for the unvaccinated women. Intention-to-treat VE against any CIN3+ was 66% (95% CI 8, 88).ConclusionsTen years post vaccination the AS04-adjuvanted HPV-16/18 vaccine shows continued efficacy against CIN3+ irrespectively of HPV type. Vaccine efficacy was not observed in baseline HPV16 DNA positive subjects.Trial registration numberNCT01393470.
- Published
- 2017