Barra Fabio, Della Corte Luigi, Noberasco Giovanni, Foreste Virginia, Riemma Gaetano, Di Filippo Claudia, Bifulco Giuseppe, Orsi Andrea, Icardi Giancarlo, Ferrero Simone
Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
J Obstet Gynaecol Res. 2020 Jul;46(7):989-1006. doi: 10.1111/jog.14276. Epub 2020 May 10.
Human papillomavirus (HPV) is the etiologic agent of the majority of cervical intraepithelial lesions (CIN) and cervical cancers. While prophylactic HPV vaccines prevent infections from the main high-risk HPV types associated with cervical cancer, alternative nonsurgical and nonablative therapeutics to treat HPV infection and preinvasive HPV diseases have been experimentally investigated. Therapeutic vaccines are an emerging investigational strategy. This review aims to introduce the results of the main clinical trials on the use of therapeutic vaccines for treating HPV infection and -related CIN, reporting the ongoing studies on this field.
Data research was conducted using MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library querying for all articles related to therapeutic vaccines for the treatment of HPV-related CIN. Selection criteria included randomized clinical trials, nonrandomized controlled studies and review articles.
Preliminary data are available on the evaluation of therapeutic vaccines for treating cervical HPV infections and CIN. Despite having in vitro demonstrated to obtain humoral and cytotoxic responses, therapeutic vaccines have not yet clinically demonstrated consistent success; moreover, each class of therapeutic vaccines has advantages and limitations. Early clinical data are available in the literature for these compounds, except for MVA E2, which reached the phase III clinical trial status, obtaining positive clinical outcomes.
Despite promising results, to date many obstacles are still present before hypothesize an introduction in the clinical practice within the next years. Further studies will draw a definitive conclusion on the role of therapeutic vaccines in this setting.
人乳头瘤病毒（HPV）是大多数宫颈上皮内病变（CIN）和宫颈癌的病原体。虽然预防性HPV疫苗可预防与宫颈癌相关的主要高危HPV类型的感染，但已对用于治疗HPV感染和HPV原位疾病的非手术和非消融替代疗法进行了实验研究。治疗性疫苗是一种新兴的研究策略。本综述旨在介绍使用治疗性疫苗治疗HPV感染及相关CIN的主要临床试验结果，并报告该领域正在进行的研究。
使用MEDLINE、EMBASE、科学网、Scopus、ClinicalTrial.gov、OVID和Cochrane图书馆进行数据研究，查询所有与治疗性疫苗治疗HPV相关CIN的文章。选择标准包括随机临床试验、非随机对照研究和综述文章。
已有关于治疗性疫苗治疗宫颈HPV感染和CIN的初步评估数据。尽管治疗性疫苗在体外已证明可获得体液和细胞毒性反应，但尚未在临床上证明始终有效；此外，每类治疗性疫苗都有其优缺点。除了已进入III期临床试验阶段并取得阳性临床结果的MVA E2外，这些化合物的早期临床数据已在文献中有所报道。
尽管结果令人鼓舞，但在假设未来几年内将其引入临床实践之前，目前仍存在许多障碍。进一步的研究将对治疗性疫苗在这种情况下的作用得出明确结论。
