June 24, 2003 - Seattle Times: RPCV Laura Koutsky develops Cervical cancer vaccine

Peace Corps Online: Peace Corps News: Headlines: Peace Corps Headlines - 2003: June 2003 Peace Corps Headlines: June 24, 2003 - Seattle Times: RPCV Laura Koutsky develops Cervical cancer vaccine

By Admin1 (admin) on Sunday, August 10, 2003 - 9:53 am: Edit Post

RPCV Laura Koutsky develops Cervical cancer vaccine

Read and comment on this excerpt from a story from the Seattle Times on RPCV Dr. Laura A. Koutsky, a professor of epidemiology at the University of Washington in Seattle who together with Dr. Kathrin U. Jansen developed a breakthrough vaccine to protect women against cervical cancer. Read the story at:

Cervical cancer vaccine effective*

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Cervical cancer vaccine effective

By Warren King
Seattle Times medical reporter

Pap-test guidelines change for those over age 30

A new vaccine against a major cause of cervical cancer has proved 100 percent effective in early testing, offering hope of preventing the second-leading cancer killer of women worldwide.

In research reported today, University of Washington scientists and their colleagues found that a Merck-developed vaccine gave complete protection against the sexually transmitted human papillomavirus (HPV) that causes half of all cervical cancers.

"It is a huge breakthrough. ... Now we can eventually see the day when we don't have to worry about deaths from cervical cancer," said Dr. Laura Koutsky, UW professor of epidemiology and principal investigator on the project.

If the vaccine continues to prove effective in a larger clinical trial, it would be a historic accomplishment in cancer prevention. Until now, the only vaccine ever proved effective in stopping a cancer-causing virus is the immunization against hepatitis B, which causes liver cancer.

The HPV-vaccine research is reported in today's edition of the New England Journal of Medicine. Other lead scientists were from the universities of Iowa, New Mexico and Indiana and from Merck Research Laboratories.

Merck already has begun testing the effectiveness of a combination vaccine that targets both of the major cervical cancer-causing human papillomaviruses (HPV). Scientists hope the vaccine will protect against 70 percent of all cervical cancers. It includes the immune-stimulating factor used in the UW-tested vaccine, which targets HPV-16, also linked to much less common cancers of the anus, vagina, vulva and penis.

The combination vaccine could be in widespread use within five years, Merck representatives said.

To volunteer for vaccine testing

The University of Washington is seeking healthy women, ages 16 to 23, to participate in the long-term study of a combination vaccine to prevent some cases of cervical cancer and genital warts.

Volunteers must plan on not becoming pregnant for seven months after enrolling or move from the Seattle area in the next four years.

The study requires 11 clinic visits. Compensation is $50 for completing enrollment and $850 for completing the study. For more information, call 206-720-5060.
Researchers envision it as a routine immunization given to teenage girls before they become sexually active and for women who might be at risk for sexually transmitted diseases.

It is too early to say whether any vaccine would eliminate the need for Pap screens because cervical cancer can be caused by many viruses.

More than 450,000 women worldwide are diagnosed with cervical cancer each year and nearly 250,000 die. That includes about 13,000 cases and 4,100 deaths annually in the United States, according to the American Cancer Society. With treatment, about 70 percent of the U.S. patients survive five years.

Worldwide, the disease ranks second only to breast cancer as the leading cancer killer of women.

If the Merck combination vaccine proves effective, it could provide more than 95 percent protection against death from cervical cancer, said Dr. Christopher Crum, an HPV expert at Brigham and Women's Hospital in Boston.

HPV-16 at some time infects about 20 percent of the U.S. population, most often without any symptoms. About 90 percent of the infections resolve without treatment.

Pap tests detect most cases of cervical cancer in the United States in time for effective treatment. But a vaccine could help eliminate abnormal test results, biopsies, worry and, if necessary, treatment, Koutsky said.

Koutsky and her colleagues tested the vaccine in 1,533 women, ages 16 to 23, in a complex study involving 16 medical facilities. Half of the women received three doses of the vaccine and half received three placebos during 1998 and 1999. The women were checked three times over an average period of 17 months after being vaccinated.

None of the women who received the vaccine became infected. But 41 of the women receiving placebos became infected and nine of those developed a condition called cervical intraepithelial neoplasia, which carries a high risk for cervical cancer.

Other studies of sexually active women in the general population have shown that 41 infections is about the number that can be expected in 765 women over about 17 months.

All of the women in the UW trial will be observed for a total of four years, but Koutsky said the interim results are excellent.

"The fact that all nine cases of HPV-16-related intraepithelial neoplasia occurred among the placebo recipients constitutes encouraging evidence of the efficacy of the vaccine," the researchers said. There were no serious side effects of the vaccine and the most common was soreness from the injection.

The vaccine contains a protein present in the capsid, or shell, surrounding the HPV-16. It worked so well that it stimulated 58 times the amount of antibodies normally found in people already infected with the virus. However, researchers say they don't yet know how long it might afford protection, or if a booster would eventually be needed.

The combination vaccine being tested by Merck also targets HPV-18, which like HPV-16, causes the deadliest form of cervical cancer. And the vaccine includes protection against HPV-6 and HPV-11, which cause some of the most common forms of genital warts.

About 20 human papillomaviruses have been linked to cervical cancer. The researchers focused on the two most dangerous for now. But Merck already is thinking about a second-generation vaccine that would incorporate more of the HPVs linked to the cancer.

"We'll need more research before designing a final (vaccine) cocktail," said Dr. Kathrin Ute Jansen, who led the laboratory research at Merck Research Laboratories in West Point, Penn.

The vaccine could help eliminate the suffering and deaths of thousands in developing countries, where Pap tests and treatment are mostly unavailable. But some wonder whether a vaccine would be within reach of such nations.

"It would be a great thing to eradicate cancer on a global basis, but you'd have to consider the social and economic impact of (delivering a vaccine). In the Third World, having the ability to see people with the timing needed and the logistics would be very challenging," said Dr. Benjamin Greer, UW director of gynecologic oncology.

Jansen said Koutsky and her UW team were essential in designing the test of the new vaccine, in understanding how HPV infects and spreads to others and in recruiting women to participate in the tests since 1984. She was elated by the research results.

"It builds on work performed by investigators worldwide for 20 years," she said. "Being involved in it has been a once-in-a-lifetime experience."

Warren King: 206-464-2247 or wking@seattletimes.com.

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