HB-200 vaccines show promised in HPV16+ cancers

Source: www.targetedonc.com
Author: Sara Karlovitch

In an interview with Targeted Oncology, Marshall Posner, MD, discusses the use of the HB-201 and HB-202 vaccines in patients with human papillomavirus 16- positive cancers.

Adding pembrolizumab (Keytruda) to the HB-200 vaccines may help to improve efficacy in patients with human papillomavirus 16- positive (HPV16+) cancers, according to data from a phase 1 study.

HPV16+ cancers are caused by the expression of E7 and E6 oncoproteins, which is a source of immunogenic neoantigens. A tumor-specific T-cell response is induced by replicating arenavirus vectors HB-201 and HB-202.

The study (NCT04180215) assessed HB-201 monotherapy and HB-201 and HB-202 alternating 2-vector therapy intravenously with or without 1 intratumoral dose in HPV16+ cancers. An interim analysis looked at 38 patients with confirmed HPV16+ cancers. In total, 18 patients received HB-201 monotherapy, 9 received the monotherapy intravenously with or without 1 intratumoral dose and 11 patients received HB-201/HB-202 alternating therapy.

In an interview with Targeted Oncology™, Marshall Posner, MD, a professor of medicine, hematology and medical oncology at Mount Sinai, discusses the use of the HB-201 and HB-202 vaccines in patients with HPV16+ cancers.

TARGETED ONCOLOGY: Can you go over the safety, efficacy, and immunogenicity of arenavirus-based vectors HB-201 and HB-202 in patients with HPV16+ cancers?

POSNER: This is a first in human phase 1 trial with expansion cohorts, to occur later, of 2 vaccines. One is a lympho-choriomeningitis virus-based arenavirus vaccine and the other is a pichinde virus-based vaccine, both of which express the E6 and E7 proteins, and both are based on viruses infecting antigen presenting cells. The E6 and E7 proteins were going to be processed and presented to the immune system in the context of an inflammatory response to the virus. Neither of these viruses are human attacking viruses, so they won’t cause any significant pathology in humans. And these were the phase one studies looking at the HB-201 vaccine by itself, and then alternating regimen with Hb-201 and HB-202, which has been shown in animal models to be actually synergistic in anti-tumor activity. This particular presentation is about the safety and potential efficacy of combining these vaccines with pembrolizumab. So, the later on trials will include pembrolizumab in the process, but this was an early attempt to see what pembrolizumab could do, but primarily to look at the safety.

We presented the first 3 patients who have progressed on the vaccines and subsequently had pembrolizumab added to the treatment. This was a modification of the original protocol to allow us to really perform the phase 1 study in an earlier fashion. All the patients who were on this particular cohort had prior checkpoint blockade inhibitor and/or other chemotherapies and checkpoint blockade inhibitors. So, this was a heavily pretreated group who had failed multiple rounds of therapy in the recurrent metastatic setting. I personally know 2 of the patients had a really extensive visceral involvement with the cancer. So, this was really a group of patients for whom you would expect to see side effects, other problems related to the tumor itself and not expect a response. And yet with them, we saw some stabilization of disease, we saw minimal impact of adding pembrolizumab. No treatment emergent adverse events that were concerning or that led to modification or reduction of dose for stopping the pembrolizumab and other treatment.

What we did see was stabilization of disease, some evidence of a response, but not robust. And we also saw no change in a robust up regulation of responsive T cells. In an L spot test, which involves stimulating the T cells from a peripheral blood with protein. The protein targets the antigen. What they saw in the initial study inpatients with the vaccine, was a big upregulation of both T cell responses and CDA responses specifically. In the addition of pembrolizumab, they did not see a further increase. They saw a maintenance or a slight reduction. So, it’s unclear what that’s about. But it does indicate that we already have robust responses, and they certainly weren’t inhibited by adding the pembrolizumab in any significant fashion.

The results of the trial will allow us to move forward in the trial that we’re doing by adding pembrolizumab to more patients. Moving forward, when we hit our recommended phase 2 dose of either the single vaccine or the double vaccine treatment, we added pembrolizumab. In the subsequent phase 1 and phase 2 expansion. I think the aim here is to go forward with a combination, rather than to do the expansion cohort with just the vaccine, but that’s up to the company and not up to me. It proved to be reasonably tolerable. There was a good safety signal and a good signal of some evidence of at least clinical responsiveness in the patients. So that was the end result of the study.

What was the reasoning behind adding pembrolizumab to the HB-200 vaccines in this patient population?

There’s some suggestion that given the patients don’t make a robust response to HPV by itself, that adding pembrolizumab would boost the response obtained with a vaccine by blocking inhibitory signals in the tumors. That is going to take some more work, you’re not going to see that early on in these kinds of trials. Although the data is suggested that it will, it’s really a small number of patients. So, that’s the rationale for doing that. It’s possible that pembrolizumab isn’t the right immune stimulant and that we need to simulate some other part of the immune system and I think as further studies go on, looking at the combination of pembrolizumab with other immune modulating drugs, that we’ll see some changes that will suggest other agents to combine with the vaccines.

What is the mechanism of action of the HB-200 vaccines with pembrolizumab and without pembrolizumab?

The presumption is that the vaccines will enhance CDH stimulation. And you’ll have activated CDA cells entering the tumor and killing the tumors based on their immune activation from the vaccine. Adding pembrolizumab would hopefully eliminate intertumoral, PD0-L1 and PD-1, inhibition of that immune response as well as inhibition of immune response with the T cells. So, those are the gross mechanisms of action. But really micro analysis of that is going to take some look at the material that the company has collected and some of the scientific laboratory investigation that they’re doing to look at that. We’re at the dawn of immunotherapy. I think the question goes right back to why do we only see a small fraction of patients responding to immunotherapy with head and neck cancer? Not as many as you would see, for example, with melanoma, but it’s still a fabulous result. But the question is really basically why are HPV-negative and HPV-positive patients not responding and are their mechanisms the same or different? Do we need to really look different modulators to the immune system in these patients?

Reference:
Ho A, Posner M, Niu J, et al. First report of the safety/tolerability and preliminary antitumor activity of HB-201 and HB-202, an arenavirus-based cancer immunotherapy, in patients with HPV16+ cancers. Jour. Clin. Oncol. 2021;39(15):2502 doi: 10.1200/JCO.2021.39.15_suppl.2502.

New cancer treatments may be on the horizon – thanks to success in mRNA vaccine trial

Source: www.goodnewsnetwork.org
Author: Andy Corbley

A personalized, mRNA vaccine, given to patients with particular kinds of aggressive cancers could leverage the immune system of the patient to kill the cancer on its own, and in doing so usher in a new epoch of cancer treatment.

Messenger RNA (ribonucleic acid) vaccines were what sparked the COVID-19 vaccine drives, as Pfizer and Moderna adapted the technology to create an emergency treatment to train the body to fight off the viral spike protein.

What most of us won’t know however, is that the mRNA vaccines were originally in development for aggressive cancer types.

Molly Cassidy, a mother studying for the Arizona Bar exam, is living proof that while the approach isn’t a panacea, it can clear away some of the most dreadful and fast cancers we know of.

After being diagnosed with head and neck cancer, she underwent surgery and chemotherapy. However it was only ten days after finishing chemo that she found a marble-like bump on her collarbone from the cancer’s swift return. Later examinations found it had spread from her ear all the way to her lungs, and she was told to get her affairs in order.

Cassidy was told she was eligible to join a clinical trial at the University of Arizona, testing an mRNA vaccine personalized to the cancer mutations of the host. By 27 weeks, Cassidy had received nine vaccine doses paired with an immunotherapy drug, and her CT scans were clear: the cancer had left her body.

Personalized Medicine
A personalized medicine approach to disease is challenging, however it could be said that the rise of cancer and of so many other diseases across the west is a result of the broader Western-health sector adopting a once-size fits all (or one-pill fits all) approach to everything from cancer to diet to mental health.

Precision or personalized medicine is becoming a little more common now, with many functional medicine clinics paying more attention to genetic phenotypes and other biomarkers before drafting a therapy plan. This approach recently broke ground in a huge way in the field of Alzheimer’s, and the USDA is using artificial intelligence based on demographics and other information to make more precise dietary guidelines.

Tailor-made mRNA vaccines are an exciting form of personalized medicine to treat cancer, and involve taking a tissue sample from the patient’s tumor and analyzing it for mutations. This not only hones the immune system into the cancerous cells, but differentiates them from healthy, non-cancerous cells.

The result is that the messenger RNA creates proteins shed from the exterior of the tumor and brings immune cells like T cells up to speed on how to fight it.

“One of the things cancer does is it can turn on signals to tell the immune system to quiet down so the cancer is not detected,” explains Daniel Anderson, a biotech scientist at MIT, to National Geographic. “The goal of an mRNA vaccine is to alert and gear up the immune system to go after the characteristic features of tumor cells and attack them.”

Currently, phase-one clinical trials are running for metastatic melanoma, GI-tract cancer, colorectal cancer, pancreatic and ovarian cancer, and non-small cell lung cancer.

One of the most exciting things, even in these early days of mRNA cancer vaccines, is that they will offer a chance at survival for advanced and incurable cancers, not only because they have the potential to be very effective, but also because patients, like in Cassidy’s case, will have no other options.

It’s likely the personalized mRNA vaccines will in practice be paired with immune checkpoint therapy—a breakthrough class of treatment that won the Nobel Prize in 2018. Similar to stem cell treatment, a patient’s T cells are drawn out before being multiplied in a lab, trained on the target cancer cell, and then reintroduced to help fight off the cancer.

Some animal studies have had success in this way, with one group of rats fighting off triple-negative breast cancer, and another group showing great success against cancer of the lymph nodes.

National Geographic concluded their feature on mRNA vaccines with a suggestion that based on early success, FDA-approval could be given in around five years.

2021-09-07T05:46:03-07:00September, 2021|Oral Cancer News|

‘Vaccine for cancer’ trial begins in Liverpool and this is how it works

Source: www.liverpoolecho.co.uk
Author: Jonathan Humphries, Public Interest Reporter

The first human trials for a groundbreaking ‘vaccine for cancer’ have begun in Liverpool with the first patients recruited.

A team of cancer researchers from Liverpool Head & Neck Centre, The Clatterbridge Cancer Centre, Liverpool University Hospitals and the University of Liverpool are trialling new vaccines that aim to harness a patients own immune system to fight cancer.

Head and neck cancers, which include mouth, throat, tongue and sinus cancers, are particularly difficult to treat and carry a high risk of returning even after successful treatment.

The first UK patient has now been recruited in Liverpool and vaccine production has begun at the Transgene laboratory in France.

More patients will be recruited in coming months, with the aim of administering the first vaccine in a few months, when the usual treatment has been completed.

The Transgene trial will involve around 30 people who have just completed treatment for advanced, but still operable, HPV-negative (not linked to human papilloma virus) squamous cell carcinoma of the head and neck (SCCHN).

How does the vaccine work?

Head and neck cancer can involve many different kinds of gene mutations resulting in the production of new proteins, called ‘neoantigens’, that vary widely between patients.

The Transgene trial aims to produce individualised ‘therapeutic vaccines’, designed to trigger an immune response to the new antigen produced by a particular gene mutation linked to each patient’s own head and neck cancer.

Chief Investigator for the UK trial, Professor Christian Ottensmeier, a Consultant Medical Oncologist at The Clatterbridge Cancer Centre and Professor of Immuno-Oncology at the University of Liverpool, explained the process.

He said: “Cancer develops because of faulty cells.

“Cells in the body are constantly reproducing and sometimes a bit of the genetic code in a cell doesn’t get copied correctly. The new cells develop with faulty genetic code.

“Most of the time, this doesn’t matter because the faulty code doesn’t do anything important.

“Occasionally, however, the faulty code is important. If the body doesn’t spot the error, these faulty cells can continue to reproduce and the person develops cancer.

“The immune system is very good at recognising anything unusual such as viruses and bacteria, and the T-cells trigger antibodies to attack and destroy them.

“Cancer cells can be very good at hiding from the immune system because, apart from the faulty bit of genetic code, they are very similar to healthy cells.

“We are creating a cancer vaccine for each patient by turning the faulty genetic code into an Achilles heel for treatment.

“We already know that the vaccine technology is very effective at waking up the immune system. We hope this means that if the patient develops cells with the same faulty code in the future, their immune system will recognise them straight away and develop antibodies to destroy them before they develop into cancer.”

Five reasons boys and young men need the HPV vaccine, too

Source: www.mskcc.org
Author: Memorial Sloan Kettering Cancer Center, News and Information

Rich Delgrosso found the lump while shaving. It was on the left side of his neck and it seemed to grow bigger by the day. He made an appointment with his ear, nose, and throat doctor.

“He said the odds were 50/50 that it was an infection,” recalls the 56-year-old father of two from Pleasantville, New York. “I asked, ‘What’s the other 50?’”

It was a possibility no one wanted to hear: Cancer. Rich underwent a biopsy and learned he had squamous cell carcinoma that had originated on the base of his tongue. His cancer, the doctor told him, was caused by the human papillomavirus (HPV).

Rich was shocked. “I knew HPV could cause cancer,” he says, “but I thought it was only cervical cancer in women.”

It’s true that HPV, a sexually transmitted virus, does cause the majority of cervical cancer cases in women. But it can also cause a variety of cancers in men, too, some of which are on the rise.

HPV led to a five-fold increase of head and neck cancers in young men from 2001 to 2017, according to data released at the 2021 American Society for Clinical Oncology annual meeting.

Memorial Sloan Kettering’s David Pfister, a medical oncologist who cares for people with head and neck cancer, says these cancer cases are just now emerging in people infected with the virus many years ago.

“Once the association between HPV infection and throat cancers was established, we better understood the significant increase in the rate of these cancers,” he says. “There is a delay between infection and the development of cancer, so there is a big reservoir of people already potentially at risk.”

But there is a way to prevent more than 90% of cancers caused by this virus: Get the HPV vaccine. It protects against head and neck cancers as well as anal cancer in both men and women. In men, it also protects against penile cancer, and in women, cervical cancer, vaginal cancer, and vulvar cancer. The vaccine is recommended for all children and can be given as early as age 9. It’s also approved for adults up to age 45.

Amidst growing concern about falling vaccination rates, MSK joined other National Cancer Institute-designated cancer centers in a May 2021 statement urging physicians, parents, and young adults to begin or keep up with HPV vaccinations, after they were interrupted by COVID-19. Early in the pandemic, HPV vaccination rates among adolescents fell by 75%. Since March 2020, an estimated one million doses of HPV vaccine have been missed by adolescents who have public insurance. That’s a decline of 21% from pre-pandemic levels.

Moreover, parents of boys are increasingly hesitant to have their sons vaccinated, according to a study in the journal Pediatrics.

MSK’s HPV Center is working to increase vaccination rates for everyone. Here are five reasons why it’s especially important for males.

1. Men get cancers caused by HPV in large numbers, too.
From 2013 to 2017, there were approximately 25,000 cases of HPV-associated cancers in women and 19,000 in men, according to the Centers for Disease Control and Prevention. More than four out of every ten cases of cancer caused by HPV are in men.

“HPV should be of concern to all since men and women are affected virtually the same by this virus,” says Abraham Aragones, an MSK physician who also studies public health.

2. There are now more cases of head and neck cancers than cervical cancers in America; HPV causes 70% of them, according to the CDC.
“My doctor told me that tumors of the neck and throat were getting more common in men,” Rich recalls.

Head and neck cancers are four times as common in men as they are in women.

3. There is no test for HPV cancers in males.
A Pap test detects early-stage cervical cancer in women. No such test exists for penile, anal, or head and neck cancers.

“Developing something like a Pap test for throat cancer would be a game-changer,” says Dr. Pfister. “When you compare the throat to the cervix, the anatomy of sites like the tonsils and the base of the tongue have hard-to-reach crevices the virus can hide in. Until an effective and reliable screening test is developed, patients should stay up to date on their HPV vaccines, know how the disease is acquired, and take any suspicious symptoms like a lump in the neck or blood in the phlegm to their doctor or dentist.”

4. The odds of getting HPV-related cancer increases with age.
“Today’s men are living longer than ever before, and that gives cancer more time to develop,” Dr. Aragones says. “Vaccination protects men from HPV-related cancers in the short and long term.”

5. The vaccine is just as safe for boys as it is girls.
The HPV vaccine went through years of rigorous safety testing before it was approved in 2006 to prevent cervical cancer in women and in 2009 to prevent HPV-related cancers in males. Since then, more than 100 million doses of the HPV vaccine have been given in the United States. Like any vaccine, there can be side effects, but they are minor, like arm soreness and fatigue. “The benefits of vaccinating against HPV far outweigh any potential risk of side effects,” says Dr. Aragones.

Rich made sure his teenage son got the HPV vaccine and says his younger daughter will follow suit.

“I didn’t want them to go through what I went through,” he says. After radiation and chemotherapy three years ago, Rich thankfully has shown no evidence of disease.

HPV-related cancers are usually able to be treated successfully. But preventing a cancer is far better than treating it, which makes the HPV vaccine a valuable weapon against cancer.

HPV vaccine leads to more than 80% drop in infections: What parents need to know

Source: Good Morning, America
Date: April 2nd, 2021
Author: Katie Kindelan

 

A new study has shown the effectiveness of the HPV vaccine, and found a dramatic decline in human papillomavirus infections in both vaccinated and unvaccinated teen girls and young women in the United States.

“This study shows that the vaccine works very well against a common virus, HPV,” Dr. Hannah Rosenblum, lead author of the study and medical epidemiologist at the Centers for Disease Control and Prevention (CDC), told “Good Morning America.”

“HPV can cause serious health problems later in life, including some cancers in both women and men,” she said. “HPV vaccination is cancer prevention — by vaccinating children at age 11 or 12, we can protect them from developing cancers later in life.”

HPV is the most common sexually transmitted infection in the United States and can cause health problems like genital warts in addition to cancer, which are most commonly cervical cancer in women and throat cancer in men, according to the CDC.

The HPV vaccine was first authorized in the U.S. for females in 2006, and for males in 2011. There has since been a more than 80% decline in HPV infections nationally, according to the CDC study.

The newly-released data from the CDC shows an 88% decrease in HPV infections among 14 to 19-year-old females and an 81% decrease among 20 to 24-year-old females.

There has also been a drop in unvaccinated females, according to Rosenblum, who warned that does not mean people should let their guard down.

“We also see an effect among unvaccinated females in these age groups due to less spread of the virus, however, unvaccinated persons are not immune and are still at risk of getting HPV,” she said. “They should talk to their doctor about getting vaccinated if they are 26-years-old or younger.”

HPV viruses are found in 80 million people in the United States, according to the CDC. There are hundreds of subtypes of HPV, and 1 in 4 people in the U.S. are infected with HPV at some point in their lives.

The CDC recommends two doses of the HPV vaccine, taken six to 12 months apart, for all girls and boys ages 11 to 12, but says the vaccine can be given to children as young as 9.

Teens and older who are not vaccinated are encouraged to do so by the age of 26. People ages 15 and older need three doses of the vaccine, according to the CDC.

The timing of the vaccine has to do with the state of children’s immune systems and also trying to vaccinate pre-teens before they are sexually active, Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and New York-Presbyterian in New York City, told “GMA.”

“Your immune system [at ages 11 and 12] is such that you have a robust response to this vaccine, and it lasts for a really long time,” she said. “But if you haven’t had it, still continue talking to your doctor about getting it up to age 26.”

Riley said she hopes the CDC’s new data — which stands out for being a 10-year study — combined with the safety of the HPV vaccine eases any remaining concerns parents may have about getting their children vaccinated against HPV.

“When [the HPV vaccine] first rolled out, the message wasn’t quite clear, so instead of people recognizing that you were going to prevent your kid from getting cancer, people were focused on the fact that HPV is a sexually transmitted disease,” she said. “The education has to continue so that parents can understand the real benefit of this vaccine.”

“The real benefit is to prevent your child from getting cervical cancer,” Riley said. “The fact that you can prevent [cervical cancer] with a vaccine that has been used for years and has shown to be safe, why wouldn’t you do it?”

Long-lasting infection with certain types of HPV is the main cause of cervical cancer, which has the best survival rates if detected early according to the CDC. Doctors routinely screen for cervical cancer with the Pap test and HPV DNA testing depending on age and risk factors.

“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” said Riley. “[Cervical cancer] is a really devastating disease.”

Globally, a woman loses her life to cervical cancer every two minutes, according to a 2019 article published in the medical journal The Lancet.

In the U.S., doctors on the frontlines like Riley said more must continue to be done to educate parents about the HPV vaccine and make sure that all children across the country have access to the vaccine. As of 2018, nearly 40% of adults ages 18 to 26 reported receiving one or more doses of the HPV vaccine, according to the CDC.

“We need to make sure that we work on access to this vaccine and make sure that all girls of all races and ethnicities have the access,” said Riley. “And we need to be sure that the message is clear so that everyone gets the two doses of the vaccine, because that’s what is associated with the best protection.”

2021-05-11T10:31:22-07:00May, 2021|Oral Cancer News|

Cancer vaccine shows early promise across tumor types

Source: www.webmd.com
Author: Walter Alexander

A personalized cancer vaccine proved possible to manufacture and was well tolerated in an early phase I clinical trial, researchers said. The vaccine, known as PGV-001, was given to 13 patients with solid tumors or multiple myeloma who had a high risk of recurrence after surgery or stem cell transplant.

At last follow-up, four patients were still alive without evidence of disease and had not received subsequent therapy, four were alive and receiving therapy, three had died, and two could not be contacted for follow-up.

Thomas Marron, MD, of Mount Sinai in New York presented these results at the American Association for Cancer Research Annual Meeting recently.

“While cancer immunotherapy has revolutionized the treatment of cancer, we know that the majority of patients fail to achieve significant clinical response,” Marron said during his presentation. Personalized vaccines may help prime an improved immune response, he said.

With this in mind, Marron and colleagues developed PGV-001, a vaccine consisting of customized peptides – a kind of amino acid — given to patients along with initial treatment.

Feasibility and safety
Vaccines were given to 13 patients. Six had head and neck cancer, three had multiple myeloma – a cancer of the white blood cells — two had lung cancer, one had breast cancer, and one had bladder cancer.

Eleven patients received all 10 intended doses, and two patients received at least eight doses.

“The vaccine was well tolerated, with only half of patients experiencing mild, grade 1 adverse events,” Marron said.

Four patients developed reactions at the injection site and one person Transient injection site reactions occurred in four patients, and one patient developed a low-grade fever.

After an exam after an average of 880 days, four patients had no evidence of cancer and had not received more therapy. This includes one patient with stage III lung cancer, one with stage IV positive breast cancer, one with stage II bladder cancer, and one with multiple myeloma.

Four patients were alive and receiving other kinds of therapy. Three patients have died, two of whom saw their cancers return.

“Our results demonstrate that the OpenVax pipeline is a viable approach to generate a safe, personalized cancer vaccine, which could potentially be used to treat a range of tumor types,” Bhardwaj said.

HPV vaccine leads to more than 80% drop in infections: What parents need to know

Source: Good Morning, America
Date: April 2nd, 2021
Author: Kathleen Kindalen

 

A new study has shown the effectiveness of the HPV vaccine, and found a dramatic decline in human papillomavirus infections in both vaccinated and unvaccinated teen girls and young women in the United States.

“This study shows that the vaccine works very well against a common virus, HPV,” Dr. Hannah Rosenblum, lead author of the study and medical epidemiologist at the Centers for Disease Control and Prevention (CDC), told “Good Morning America.”

“HPV can cause serious health problems later in life, including some cancers in both women and men,” she said. “HPV vaccination is cancer prevention — by vaccinating children at age 11 or 12, we can protect them from developing cancers later in life.”

HPV is the most common sexually transmitted infection in the United States and can cause health problems like genital warts in addition to cancer, which are most commonly cervical cancer in women and throat cancer in men, according to the CDC.

The HPV vaccine was first authorized in the U.S. for females in 2006, and for males in 2011. There has since been a more than 80% decline in HPV infections nationally, according to the CDC study.

The newly-released data from the CDC shows an 88% decrease in HPV infections among 14 to 19-year-old females and an 81% decrease among 20 to 24-year-old females.

There has also been a drop in unvaccinated females, according to Rosenblum, who warned that does not mean people should let their guard down.

“We also see an effect among unvaccinated females in these age groups due to less spread of the virus, however, unvaccinated persons are not immune and are still at risk of getting HPV,” she said. “They should talk to their doctor about getting vaccinated if they are 26-years-old or younger.”

HPV viruses are found in 80 million people in the United States, according to the CDC. There are hundreds of subtypes of HPV, and 1 in 4 people in the U.S. are infected with HPV at some point in their lives.

The CDC recommends two doses of the HPV vaccine, taken six to 12 months apart, for all girls and boys ages 11 to 12, but says the vaccine can be given to children as young as 9.

Teens and older who are not vaccinated are encouraged to do so by the age of 26. People ages 15 and older need three doses of the vaccine, according to the CDC.

The timing of the vaccine has to do with the state of children’s immune systems and also trying to vaccinate pre-teens before they are sexually active, Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and New York-Presbyterian in New York City, told “GMA.”

“Your immune system [at ages 11 and 12] is such that you have a robust response to this vaccine, and it lasts for a really long time,” she said. “But if you haven’t had it, still continue talking to your doctor about getting it up to age 26.”

Riley said she hopes the CDC’s new data — which stands out for being a 10-year study — combined with the safety of the HPV vaccine eases any remaining concerns parents may have about getting their children vaccinated against HPV.

“When [the HPV vaccine] first rolled out, the message wasn’t quite clear, so instead of people recognizing that you were going to prevent your kid from getting cancer, people were focused on the fact that HPV is a sexually transmitted disease,” she said. “The education has to continue so that parents can understand the real benefit of this vaccine.”

“The real benefit is to prevent your child from getting cervical cancer,” Riley said. “The fact that you can prevent [cervical cancer] with a vaccine that has been used for years and has shown to be safe, why wouldn’t you do it?”

Long-lasting infection with certain types of HPV is the main cause of cervical cancer, which has the best survival rates if detected early according to the CDC. Doctors routinely screen for cervical cancer with the Pap test and HPV DNA testing depending on age and risk factors.

“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” said Riley. “[Cervical cancer] is a really devastating disease.”

Globally, a woman loses her life to cervical cancer every two minutes, according to a 2019 article published in the medical journal The Lancet.

In the U.S., doctors on the frontlines like Riley said more must continue to be done to educate parents about the HPV vaccine and make sure that all children across the country have access to the vaccine. As of 2018, nearly 40% of adults ages 18 to 26 reported receiving one or more doses of the HPV vaccine, according to the CDC.

“We need to make sure that we work on access to this vaccine and make sure that all girls of all races and ethnicities have the access,” said Riley. “And we need to be sure that the message is clear so that everyone gets the two doses of the vaccine, because that’s what is associated with the best protection.”

Which COVID-19 vaccine is best for cancer patients?

Source: www.mdanderson.org/
Author: Cynthia DeMarco

With three COVID-19 vaccines now authorized for emergency use by the Food and Drug Administration (FDA), you might be wondering which vaccine is best for current and former cancer patients. After reviewing all available data, MD Anderson medical experts agree that all three vaccines are safe and recommended for cancer patients.

So, should you take Johnson & Johnson’s Janssen COVID-19 vaccine (J&J), which requires only one dose, if that’s what’s available? Or should you wait for one of the Pfizer or Moderna vaccines, which both require two doses, spaced 21 and 28 days apart, respectively?

According to our experts, the answer is clear: “Don’t pass up an opportunity to get the vaccine, no matter which one it is,” says Anita Ying, M.D., vice president of Ambulatory Medical Operations. “The best COVID-19 vaccine to get is the first one available to you.”

Timing matters for cancer patients getting a COVID-19 vaccine
Ying’s advice is particularly true for cancer patients, since some may be immunocompromised, making them both more vulnerable to severe infections and more likely to need hospitalization should they contract COVID-19.

“The sooner you can start building resistance to the novel coronavirus, the sooner you’ll have at least some protection against it,” notes infectious diseases specialist David Tweardy, M.D. “And that benefits everyone.”

For patients in active treatment, a COVID-19 vaccine will likely be more effective when coordinated with their treatment schedules. Those who have recently had surgery should wait two weeks before receiving one. And those enrolled in clinical trials, or who are receiving chemotherapy, CAR T cell therapy, immunotherapy or stem cell transplants should consult their care teams for additional guidance on timing.

Other timing considerations apply for those who’ve received a different vaccine recently, who’ve received monoclonal antibody therapy or convalescent plasma to treat a COVID-19 infection.

Everyone else can receive a COVID-19 vaccine as soon as one becomes available to them.

Benefits of all three vaccines outweigh risks of COVID-19
No matter which COVID-19 vaccine you get, you can rest assured that it is both safe and effective in protecting against severe infections. Vaccines must be at least 50% effective at preventing symptomatic infection in order to be authorized by the Food and Drug Administration.

“The Pfizer and Moderna vaccines are 95% and 94% effective, respectively, at preventing symptomatic infection,” says Tweardy. “The Johnson & Johnson vaccine is 67% effective overall.”

At first glance, that may make the J&J vaccine look slightly less desirable. But both the J&J and the Pfizer vaccines were 100% effective at preventing hospitalizations and death due to COVID-19, and the Moderna vaccine was 89% effective. The J&J vaccine also had the second-highest rates of efficacy at preventing severe infections: 77% after 14 days and 85% after 28 days.

“The overall numbers are different,” notes Tweardy. “There’s no getting around that. But when you consider the fact that different strains of the virus were circulating at the time the Johnson & Johnson one was being tested, it’s really not a fair comparison. What we’re looking for is a vaccine that prevents death and allows patients to survive the infection, and that’s exactly what the Johnson & Johnson one does, just as effectively as the other two.”

One dose or two: choosing the COVID-19 vaccine that’s right for you
Though their methods of accomplishing it differ slightly, all of the current COVID-19 vaccines work by inducing people’s bodies to produce a spike protein dotting the novel coronavirus’ surface. Recipients’ immune systems then recognize the protein as an invader and start generating antibodies against it.

This immune response is what makes vaccine recipients much less likely to develop a COVID-19 infection, should they ever be exposed to it. And that’s why it’s best to be vaccinated as quickly as possible.

Still, there may be some situations in which it makes more sense to opt for the Johnson & Johnson vaccine. For one thing, the J&J vaccine requires only one dose to be effective, while the Pfizer and the Moderna vaccines require two, spaced several weeks apart. That means you could achieve the maximum protection afforded by the J&J vaccine in a much shorter time period.

“The goal is to start building up resistance as quickly as possible,” says Tweardy. “So, the sooner you can launch that process, the better. But if you’re really afraid of needles or unable to commit to receiving a second dose at the recommended time, Johnson & Johnson might be a better option for you, if it’s available.”

When a vaccine opportunity knocks, don’t hesitate
One of the most important things to keep in mind is that supplies of the COVID-19 vaccine are still limited across the country. So, if an opportunity arises to get a COVID-19 vaccine, think very hard before letting it pass you by — especially if the only reason you’d be doing so because it’s not the vaccine you’d prefer most.

“It might be several weeks or months before you get another opportunity,” adds Ying. “And it may or may not be the one you want. So, in my opinion, it’s not worth missing the chance to be vaccinated.”

More parents balking at giving kids cancer-fighting HPV vaccine

Source: www.usnews.com
Author: Steven Reinberg

From 2012 to 2018, more doctors recommended their patients get vaccinated with the HPV vaccine — from 27% to 49%. But at the same time, the number of parents who were reluctant to have their kids vaccinated increased from 50% to 64%, researchers found.

“Overall, more U.S. teens are getting the HPV vaccine, and the nation is making progress towards reaching the HPV vaccination goals; however, if parental reluctance continues to grow, the current rate of our progress might plateau or possibly decline,” said lead study author Kalyani Sonawane. She’s an assistant professor in the department of management, policy and community health at the University of Texas Health Science Center in Houston.

“In the long term, the lost opportunity to protect our teens from HPV might contribute to cases of HPV-associated cervical, oropharyngeal, penile, anal, vaginal and vulvar cancers in the future,” Sonawane said.

Parents’ reluctance to have their kids vaccinated rose more for girls, from 54% to 68%, compared with 44% to 59% for boys, the researchers noted. The report was published online Feb. 9 in the journal Pediatrics.

To increase the number of boys and girls who get vaccinated, doctors need to strongly recommend it, Sonawane said.

“Further improvements in provider recommendations can be made, given that it is the most important factor for improving HPV vaccine uptake,” she said. “Providers should be prepared to tackle hesitancy by conveying the importance of HPV vaccination to parents and debunking vaccine misinformation. Increasing vaccine confidence in parents will be key to attaining HPV vaccination goals in the U.S.”

The reluctance is largely due to safety concerns, Sonawane said. In a study, she and her colleagues found that the most common reason parents cite for their reluctant to HPV vaccine is concerns regarding adverse effects.

“The public message about the HPV vaccine should highlight that the vaccine protects against cancers. It is important to emphasize to parents that the vaccine offers protection for up to six cancers, because data indicates that many people are not aware of this fact,” Sonawane said.

In another study, Sonawane found that less than one-third of Americans know that HPV causes anal, penile and oral cancers.

Sonawane added that the anti-vaxxer movement is likely contributing to the growing reluctance of parents to have their children vaccinated, and she is concerned that the “negative coverage of the COVID vaccine will trickle down to HPV vaccine and affect perceptions regarding vaccines.”

HPV is a sexually transmitted infection that is the cause of most cervical, vagina and vulva cancers, penis cancer and cancer in the back of the throat. It can take years for these cancers to develop, but children can be protected by getting the HPV vaccine at ages 11 to 12, according to the U.S. Centers for Disease Control and Prevention.

One pediatrician unconnected to the study noted the importance of the marketing for the vaccine.

“When this vaccine first hit the market, they didn’t focus the messaging around it being a cancer preventer vaccine. They focused on the sexually transmitted infections,” said Dr. David Fagan, vice chairman of pediatric administration-ambulatory at Cohen Children’s Medical Center in New Hyde Park, N.Y.

Fagan believes, however, the message should be that the vaccine prevents cancer. “Wouldn’t you, as a parent, want to do everything you could for your child to prevent the possibility of your child getting a cancer — this vaccine does that,” he said.

He also thinks that the quality of the recommendation is key to convincing parents to vaccinate their children.

The American Academy of Pediatrics is doing a lot to educate pediatricians in motivational interviewing techniques, Fagan said.

The tetanus booster, the meningitis vaccine and the HPV vaccine are those recommended for adolescence.

Evidence shows, if you offer the HPV in first or second place as opposed to third place, parents are more likely to opt for it, Fagan said.

“If you do tetanus, meningitis, HPV, they are less likely to accept HPV, but if you put HPV first or even second, there’s evidence that there’s better uptake. So messaging is really, really important,” he said.

The vaccine is safe, Fagan said. A study has shown that no serious side effects have been seen since the vaccine was released.

“You know these things on social media about the safety of the vaccine, obviously that’s crazy stuff,” he said.

“I tell parents if this vaccine was unsafe, it would have been pulled from the market,” Fagan said. “Additionally, you would be reading about multimillion dollar legal settlements in the press, and that has not happened. So the take-home message is this vaccine is safe and effective in preventing cancers caused by HPV.”

More information
For more on the HPV vaccine, go to the U.S. Centers for Disease Control and Prevention.

Sources:
Kalyani Sonawane, Ph.D., assistant professor, department of management, policy and community health, University of Texas Health Science Center at Houston; David Fagan, MD, vice chairman, Pediatric Administration-Ambulatory, Cohen Children’s Medical Center, New Hyde Park, N.Y.; Pediatrics, Feb. 9, 2021, online

2021-02-10T10:56:54-07:00February, 2021|Oral Cancer News|

How enlisting dentists can speed up Covid-19 vaccinations

Source: Knowable Magazine
Date: February 3rd, 2021
Author: Mary E. Northridge

OPINION: Dental care providers have the skills, the facilities and the trust of patients who might otherwise miss out

 

Even as the Biden administration has upped its Covid-19 vaccine goal to 1.5 million per day, early reports say vaccination rates are lagging in hard-hit Black and Latino communities. On both fronts, America’s dentists can help.

Dental professionals — dentists, dental hygienists and dental assistants — have been responding to the pandemic from the outset, even as many practices were shut down by the emergency. At the health center where I work in Brooklyn, dental providers first donated their personal protective equipment (PPE) to the affiliated hospital. Then many of them were redeployed to perform arterial blood gas measurements and even transport deceased patients to makeshift morgues.

Today, the urgent need is to get millions of shots in arms. States should immediately authorize dental providers to administer Covid-19 vaccines. That would not only expand the trained immunization workforce, it would open up additional sites to dispense the vaccine and bolster vaccine acceptance among patients who do not routinely go to the doctor.

This is not without precedent. In 2019, Oregon became the first state to allow dentists to offer any vaccine to patients. Other states, including Illinois and Minnesota, allow dentists to administer influenza vaccines. Since late 2020, Arkansas, Massachusetts and California have permitted dentists to administer Covid-19 vaccines.

During this devastating public health emergency, this idea needs to be extended to all states.

There are more than 110,000 dentists – excluding specialists — and over 200,000 hygienists in the United States, and they already have the skills needed. Dentists routinely administer intra- and extra-oral injections to provide anesthesia, so any additional training would be minimal. In California, for instance, dentists will do four hours of online training before joining the vaccination effort.

California currently plans to utilize dentists just as extra manpower at vaccine clinics. But dental offices, too, will be valuable in vaccinating hard-to-reach populations.

Dental offices and clinics are a safe location. Despite early concerns that they might be particularly vulnerable to aerosol-borne transmission of the novel coronavirus, evidence is mounting that transmission at dental sites is rare. As in medical settings, precautions such as using PPE and increasing ventilation are effective. Nearly all dental practices and clinics have reopened to provide care. And that has been essential during the pandemic: Treating damaged teeth, tooth decay, gum disease and oral sores before they become acute prevents patients from going to emergency departments because of dental pain.

Interrupting community spread, however, is the chief imperative to prevent Covid-19 cases from overwhelming hospitals today. And that means adding vaccines to dental services.

Inoculating patients who are already in chairs for dental visits could improve vaccine acceptance. At the health center where I work, a simple workflow change for preventive tooth sealant placement nearly doubled the number of eligible children treated, from 37 percent to nearly 78 percent. Rather than schedule a separate appointment, sealants were applied during the kids’ initial or recall visits. Fewer visits meant greater acceptance of the treatment and higher rates of completion. The same could be true for vaccines.

Community dental clinics also serve hard-to-reach patients — minorities, immigrants, impoverished people — those who may be hesitant to seek out the vaccine because of historical injustices, fear of deportation or lack of health insurance. But dental providers have often earned trust through longstanding service in these communities. Ongoing quality improvement studies at our health center, for instance, document no racial/ethnic bias in treatment by dental providers. When patients are treated with respect regardless of their ability to pay for services, they may be more willing to accept a vaccine that will protect them, their families and their communities.

Many states have suspended regulations and expanded the scope of dental practices to combat the pandemic. To help ensure health equity and successfully immunize the whole US population, all states ought to enlist dental providers to administer Covid-19 vaccines as well.

This article is part of “Reset: The Science of Crisis & Recovery,” an ongoing Knowable Magazine series exploring how the world is navigating the coronavirus pandemic, its consequences and the way forward. “Reset” is supported by a grant from the Alfred P. Sloan Foundation. 

 

2021-02-08T12:25:34-07:00February, 2021|Oral Cancer News|
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