Vaccines to treat human papillomavirus could be a significant innovation in the fight against cervical cancer

Innovative vaccines are being developed that could potentially treat dangerous human papillomavirus (HPV) infections in adults and therefore reduce risks of cervical cancer, according to a new report released today by the World Health Organization (WHO).

Currently, vaccines exist to prevent, but not treat HPV infections, which are the main cause of cervical cancer. Using the latest immunotherapy advances, however, “therapeutic” vaccines are now also being developed that could clear HPV or treat precancerous cells in those already exposed to the virus.

To ensure maximum public health benefits, the report, WHO preferred product characteristics for therapeutic HPV vaccines calls on developers to ensure these products are designed to be used not only in wealthier contexts but also in low- and middle-income countries, where more than 90% of cervical cancer-related deaths occur.

“To eliminate cervical cancer, it will be essential to expand access to existing interventions now – lifesaving preventive vaccinations, timely screenings, and effective treatment – all are critical for success,” said Dr Sami Gottlieb, a medical doctor and epidemiologist within WHO’s Department of Sexual and Reproductive Health and Research. “Therapeutic HPV vaccines could be a catalytic innovation to complement these efforts, increasing options for the millions of women who have already acquired HPV and reducing their risks of developing life-threatening cancer in the future.”

Eliminating cervical cancer – which kills one woman every 90 seconds – is a major public health initiative for WHO. The key goals of WHO’s Cervical Cancer Elimination Initiative are, by 2030, to:

• vaccinate 90% of girls with preventive HPV vaccines;
• screen 70% of women with a high-performance test like HPV DNA screening; and
• treat 90% of women who have precancerous cells in the cervix or cervical cancer.

A therapeutic vaccine for HPV could supplement these existing approaches. Such vaccines aim to boost the body’s immune response so that it can either fight and clear high-risk strains of the virus or abnormal “precancerous” cells. It is likely to be especially beneficial for adult women who did not receive the HPV vaccination before contracting the virus and in poorer countries, where millions of women still lack access to effective cervical screening and cancer treatments.

There are currently over 20 therapeutic HPV vaccine candidates at different stages of development, with several in clinical trials. The new report aims to guide vaccine developers to ensure their products meet global public health needs and to enable vaccines to be rolled out more quickly if approved. It considers medical indications for potential use of such a vaccine, target populations, safety and efficacy criteria, as well as practical considerations such as delivery strategy, storage and dosage schedules, and affordability.