Trial Confirms Efficacy of HPV Vaccine, Shows Cross-Protection

Source: National Cancer Institute End-of-trial results from a trial testing Cervarix, a vaccine against human papillomavirus (HPV) types 16 and 18, showed that the vaccine continued to provide substantial protection against cervical precancers 4 years after vaccination. Cervarix provided almost complete protection in young women who had no evidence of exposure to HPV at the time of vaccination. The vaccine provided less protection for the total vaccinated cohort and was less effective with increasing age at vaccination. These findings reflect the vaccine’s lack of effectiveness against infections acquired before vaccination. The vaccine also partially protected women against four types of HPV that are not targeted by the vaccine. (Although HPV-16 and -18 cause about 70 percent of cervical cancers worldwide, as many as 15 HPV types can cause cancer.) These results from the PATRICIA trial (Papilloma Trial against Cancer in Young Adults) were published online November 9 in Lancet Oncology in two separate papers, available here and here. The PATRICIA trial enrolled 18,644 young women between the ages of 15 and 25 from 14 countries. The participants were randomly assigned to receive either three doses of Cervarix or three doses of a hepatitis A vaccine as a control. Results from the interim analysis, published in July 2009, showed that the vaccine greatly reduced the risk of grade 2 cervical intraepithelial neoplasias and higher (CIN2+). The new analysis shows that, 4 years after vaccination, Cervarix provided complete protection against grade 3 cervical intraepithelial neoplasias or higher (CIN3+) associated with HPV-16 and [...]

2011-11-29T18:55:35-07:00November, 2011|Oral Cancer News|

Protein inhibitor may supply contemporary HPV treatment

Source: Researchers from Tufts University School of Medicine have developed a protein-based inhibitor that could provide a topical treatment for HPV as an alternative to surgical and harsh chemical treatments (FASEB Journal, April 11, 2011). HPV affects about 20 million people in the U.S., making it the most common sexually transmitted infection. There are more than 100 types of HPV, of which more than 40 are sexually transmitted. These include two high-risk types, HPV-16 and HPV-18, which cause the majority of cervical and anogenital cancers, and some portion of head and neck cancers, particularly oral cavity and oropharynx cancers. "Currently, there is no cure for HPV, and the available treatment options involve destroying the affected tissue. We have developed a protein inhibitor that blocks HPV protein expression in cell culture, a first step toward a topically applied treatment for this cancer-causing virus," said senior author James Baleja, PhD, an associate professor of biochemistry at Tufts University School of Medicine. In their efforts to inhibit HPV, Baleja and his team zeroed in on the viral protein E2, which controls viral activities including DNA replication and the activation of cancer-causing genes. Using structure-guided design, the team developed a protein called E2R that prevents E2 from functioning normally. When the researchers applied E2R to a cell model of HPV biology, viral gene transcription was halted. Because HPV infects epithelial cells, the outermost layer of the skin, and the mucous membranes, protein inhibitors such as E2R could be applied in a topical form. [...]

Oral cancer: How discovery devices assist screenings

Source: Author: Nick Efthimiadis, Vice President, Sales & Marketing, LED Dental Inc. As the intense media attention surrounding Michael Douglas’s illness clearly demonstrated, oral cancer is increasingly in the news these days. With the unfortunate growth in the number of relatively young people contracting the disease due to exposure to the sexually-transmitted human papilla virus — specifically, the HPV-16 strain — oral cancer will only become a bigger concern for both patients and dental practices over time. In fact, the Oral Cancer Foundation recently announced that HPV-16 has now replaced tobacco as the leading cause of this disease. Sadly, one North American dies every hour of every day from oral cancer, and many of those who survive the disease are forced to deal with lengthy, painful treatment and permanent disfigurement. The main problem is that oral cancer is typically discovered in late stages, when the five-year survival rate is only around 30%. The good news: when discovered early, the survival rate leaps to 80%-to-90%. The key to early discovery is the dental practice. Ideally, each and every practice should be conducting a two-step oral cancer screening on all adult patients as part of their annual or semi-annual hygiene checkup. The first step consists of a conventional “white light” exam comprising visual inspection and palpation. The second step consists of examination with an adjunctive screening device. Fortunately, the two steps should take no more than five minutes combined. For the past several years, the adjunctive device that has [...]

AAOMS Supports Goals of Oral Cancer Awareness Week

ROSEMONT, Ill., April 1, 2011 /PRNewswire-USNewswire/ -- The 2011 Oral Cancer Awareness Week, set for April 11-15, is intended to educate people of all ages and socio-economic levels about the risk factors and symptoms of oral, head and neck cancer and the importance of early detection. The American Association of Oral and Maxillofacial Surgeons (AAOMS) agrees with the Oral Cancer Foundation, which conceived the awareness week observance, that it is critical oral cancers receive the national media attention necessary to raise public awareness. The Oral Cancer Foundation points out that the high death rate traditionally associated with oral cancer is not because it is hard to discover or diagnose, but because the cancer has historically been discovered late in its development.  In its early stages, oral cancer may – and often does - go unnoticed because there are no blatant symptoms or pain.  This only underscores the importance of establishing a regimen to include regular self-examinations and examination by a dentist or oral and maxillofacial surgeon at least annually. The mouth is one of the easiest parts of your body to examine yourself. Also, changes in the mouth can be easily seen, so oral cancer can be detected in its early stages. The key to early detection is performing a self-examination regularly. Examining your mouth each month will help you identify changes or new growths early. And, early detection is important in increasing the chance of a cure. Factors That May Cause Cancer According to the National Institutes of Health, [...]

We owe it to our sons to protect them against human papilloma virus – the new oral cancer peril

Source: Author: Professor Lawrence Young The seemingly unstoppable rise of throat and mouth cancers over the past two decades has left experts baffled and deeply concerned. These are truly horrible diseases. More than 15,000 new patients are diagnosed each year in Britain alone and almost 8,000 die from the most common type, cancer of the oesophagus. Two-thirds of sufferers are men. And those that survive are often left horrifically disfigured by aggressive radiotherapy and surgery. Most worryingly, numbers of new cases have doubled since 1989. We used to think most oral and throat cancers - which also include laryngeal (voice box), tracheal (windpipe) and oropharyngeal (soft-palate) tumours - were due to a lifetime of smoking and heavy alcohol consumption, and only really occurred in old age. But as health messages hit home, numbers of smokers and drinkers dropped, fewer older men and women developed these cancers and a new group of patients - middle-class, middle-aged men who drank moderately and had never smoked - emerged. This was a surprise. Small studies, in which tumours were analysed, indicated a new culprit: the human papilloma virus (HPV), the same virus that we knew was the cause of cervical cancer in women. For years there have been whisperings among oncologists that this could become one of the most significant cancer challenges of the 21st Century. And six weeks ago, evidence published by two American universities showed that these fears were becoming a reality. Researchers found that about half of the [...]

Revealed: oral sex is ‘bigger cause of throat cancer than tobacco’

Source: Author: staff A virus spread during oral sex is now the main cause of throat cancer in people under 50, scientists have warned. They say the human papilloma virus spread during unprotected sex is to blame for a disturbing rise in potentially deadly oral cancers in the last few decades. Doctors have called for boys to be vaccinated against HPV just like teenage girls to stop the spread of the disease. HPV is best known as the cause of around 70 per cent of cervical cancers. Since 2008, girls have been vaccinated against the virus aged 12 and 13 in schools. However, it can also cause warts, verrucas and other cancers. Cancers of the mouth and oropharynx - the top of the throat - used to be mainly diagnosed in older men who drink or smoke. But increasingly, it is being seen in younger men. Prof Maura Gillison of Ohio State University in Columbus said the sexually transmitted HPV was a bigger cause of some oral cancers than tobacco. She said: 'We don’t know from strict scientific evidence whether the vaccine will protect from oral HPV infections that lead to cancer. Those of us in the field are optimistic it will – the vaccines in every anatomical site looked at so far have been shown to be extraordinarily effective, about 90 per cent effective, at preventing infections.' 'When one of my patients asks whether or not they sound vaccinate their sons, I say certainly.' Girls aged 12 and [...]

2011-02-21T12:58:57-07:00February, 2011|Oral Cancer News|

Quadrivalent HPV vaccine may be effective in young men

Source: Author: Laurie Barclay, MD; Charles P. Vega, MD Quadrivalent human papillomavirus (HPV) vaccine may prevent infection with HPV types 6, 11, 16, and 18 and the development of related external genital lesions in young men 16 to 26 years old, according to the results of a randomized, placebo-controlled, double-blind trial reported in the February 3 issue of the New England Journal of Medicine. "Infection with ...HPV and diseases caused by HPV are common in boys and men," write Anna R. Giuliano, PhD, from the Risk Assessment, Detection, and Intervention Program, H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues. "We report on the safety of a quadrivalent vaccine (active against HPV types 6, 11, 16, and 18) and on its efficacy in preventing the development of external genital lesions and anogenital HPV infection in boys and men." The study sample consisted of 4065 healthy boys and men, aged 16 to 26 years, enrolled from 18 countries. The primary efficacy goal was to demonstrate that use of the quadrivalent HPV vaccine was associated with a lower incidence of external genital lesions related to HPV-6, 11, 16, or 18. The investigators used a per-protocol population, in which participants received all 3 vaccinations and had tested negative for relevant HPV types at enrollment, and an intent-to-treat population, in which participants received vaccine or placebo, regardless of baseline HPV status. In the intent-to-treat population, there were 36 external genital lesions in the vaccine group and 89 in the [...]

2011-02-15T13:47:01-07:00February, 2011|Oral Cancer News|

HPV: To test or not to test

Source: Author: Nancy W. Burkhart, RDH, EdD The dental practitioner has a responsibility to examine and assess the oral tissue status of all patients. Usually, we are happy to report that the tissue is healthy and no further treatment is necessary. Ethically, our role in assessment is both an understood practice as well as a legal one each time we interact with our patients. Within your practice, what is the expected role in assessing and relaying advice/recommendations to our patients? Do we rely strictly on scientific evidence with evidence-based protocol? Do we trust the developers/promoters of dental products to provide information to us? Do we relay personal opinion from colleagues, or do we reject opinion-based information? Do we search the scientific literature for current information, or call our colleagues and company representatives and obtain a consensus of what the best options may be for dissemination of information? We have all been in these situations. With busy practices, it is very time consuming to sit down and evaluate all the literature. Anyone who has been faced with a medical decision for a loved one or ourselves may actually feel exhausted while trying to sort through all of the options, treatments, and advice – some of which may even be at odds within specific group specialties in the way treatment is rendered. It can be very daunting, draining us both mentally and physically. So how do we approach this dilemma? For some time, we have known about the detrimental [...]

High-risk human papillomavirus in esophageal squamous cell carcinoma

Source: Authors: Annika Antonsson et al Background: Although most cases of esophageal squamous cell carcinoma (ESCC) in western populations have been attributed to high levels of exposure to tobacco and alcohol, infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). Methods: To explore this issue, we analyzed HPV DNA prevalence and HPV types together with lifestyle factors, in relation to tumor stage and survival in a low-incidence population. Archived tumor samples from a nationwide cohort of 222 ESCC patients were tested for the presence of HPV DNA by PCR; positive samples were sequenced to determine HPV type, and p16INK4a status was assessed by immunohistochemistry. Results: Of 222 ESCC patients, 8 tested HPV positive (prevalence, 3.6%; 95% confidence interval, 1.1-6.1%), of which 6 were HPV-16 positive and 2 were HPV-35 positive. Four of the eight HPV-positive tumors overexpressed p16INK4a. None of 55 normal esophageal tissue samples from healthy participants had any detectable HPV. Although the numbers were low, it seemed that patients with HPV-positive ESCC tumors were younger than those with HPV-negative tumors (mean age, 60.8 versus 65.3 years, P = 0.18) and had higher body mass index (BMI) throughout life (mean current BMI of 25.1 for HPV positive, 22.2 for HPV negative, P = 0.08; mean BMI at 20 years of 25.8 for HPV positive, 22.1 for HPV negative, P = 0.003). We found no difference between patients with HPV-positive and HPV-negative tumors with respect to other lifestyle factors. Conclusions: These findings suggest a very low [...]

Human papilloma virus (HPV) and cancer

Source: Author: David Warmflash, MD Human papilloma virus (HPV), is a category of viruses of which more than seventy subtypes are known. Most people have heard of HPV, because the media have spent a good deal of time discussing the issue of mandatory vaccination against the virus. The discussion in the news is well-deserved. Each year, approximately 6.2 million people are infected with (HPV). Usually, the virus is cleared by the immune system, before any disease can develop. However, because of the high rate of infection, HPV-associated disease is all-too common around the world. Each year 11,000 new cases of invasive cervical cancer are diagnosed in the United States, leading to approximately 4,000 deaths. The rate would be much higher, were it not for the advent of the the Papanicolaou test (Pap smear), used to screen for precancerous conditions since the 1930s. Since Pap smears and HPV vaccinations are hot topics, even if you have no background in medicine, it is likely that you are aware of HPV as an agent that causes cervical cancer. What you may not know, however, is that HPV also is involved in cancers of the throat and the skin. Actually, not all of the subtypes of HPV are known to be involved in the pathological process leading to cancer and precancerous conditions of the cervix. Of the HPV subtypes linked to cervical cancer, four types are most important. These are HPV-6b, HPV-11, HPV-16, and HPV-18, the latter two being the most dangerous for [...]

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