Infection and Drug Resistance (Jul 2019)
Recombinant human papillomavirus nonavalent vaccine in the prevention of cancers caused by human papillomavirus
Abstract
Zheng Quan Toh1,2, Jennie Kosasih,1 Fiona M Russell1,3, Suzanne M Garland4,5, Edward K Mulholland1,6, Paul V Licciardi1,21Infection and Immunity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia; 2Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; 3Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; 4Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia; 5Regional WHO HPV Reference Laboratory, Centre for Women’s Infectious Diseases Research, The Royal Women’s Hospital, Parkville, Victoria, Australia; 6Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, University of London, London WC1E7HT, UKAbstract: Human papillomavirus (HPV) types 16 and 18 cause 70% of cervical cancer cases globally. The nonavalent HPV vaccine (9vHPV) was licensed in 2014 and protects against the next five most common cancer-causing HPV types (HPV 31/33/45/52/58) after HPV 16/18. Phase III clinical studies have demonstrated high vaccine efficacy (>90%) against cervical, vulvar, and vaginal precancers caused by these additional types, and have shown comparable immunogenicity to the shared genotypes to quadrivalent HPV vaccine (4vHPV). Vaccine efficacy and antibody responses for 9vHPV are found to persist for at least five years while longer-term observational studies are ongoing to monitor long-term vaccine effectiveness. The implementation of 9vHPV has the potential to prevent up to 93% of cervical cancer cases, as well as a significant proportion of other HPV-related anogenital cancers. This review article summarizes the current evidence for 9vHPV in terms of vaccine efficacy against HPV infection and related anogenital precancers, safety, and immunogenicity, as well as discussing the potential impact of this vaccine on the cervical cancer burden globally.Keywords: nonavalent human papillomavirus vaccine, review, efficacy, immunogenicity, safety