Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

Donato, Violante Di; Caruso, Giuseppe; Petrillo, Marco; Kontopantelis, Evangelos; Palaia, Innocenza; Perniola, Giorgia; Plotti, Francesco; Angioli, Roberto; Muzii, Ludovico; Panici, Pierluigi Benedetti; Bogani, Giorgio

doi:10.3390/vaccines9050410

Cited by 53 publications

(63 citation statements)

References 47 publications

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“…The best available evidence regards the prevention of recurrent CIN after surgical treatment [36][37][38]. A recent meta-analysis [39], including 11 studies and 21,310 patients, demonstrated that providing HPV vaccine as an adjunct to conization for CIN reduces the risk of recurrence. The present meta-analysis added another study (Karimi et al, 2020) [31] with 312 more patients to the previous analysis by Di Donato et al [39], and confirmed that HPV vaccination reduces the risk of CIN recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis [39], including 11 studies and 21,310 patients, demonstrated that providing HPV vaccine as an adjunct to conization for CIN reduces the risk of recurrence. The present meta-analysis added another study (Karimi et al, 2020) [31] with 312 more patients to the previous analysis by Di Donato et al [39], and confirmed that HPV vaccination reduces the risk of CIN recurrence. On the other hand, our systematic research revealed that there are scant data regarding the other HPV-related diseases.…”

Section: Discussionmentioning

confidence: 99%

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HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis

et al. 2022

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Objective: To assess evidence on the efficacy of adjuvant human papillomavirus (HPV) vaccination in patients treated for HPV-related disease across different susceptible organ sites. Methods: A systematic review was conducted to identify studies addressing the efficacy of adjuvant HPV vaccination on reducing the risk of recurrence of HPV-related preinvasive diseases. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Sixteen studies were identified for the final analysis. Overall, 21,472 patients with cervical dysplasia were included: 4132 (19.2%) received the peri-operative HPV vaccine, while 17,340 (80.8%) underwent surgical treatment alone. The recurrences of CIN 1+ (OR 0.45, 95% CI 0.27 to 0.73; p = 0.001), CIN 2+ (OR 0.33, 95% CI 0.20 to 0.52; p < 0.0001), and CIN 3 (OR 0.28, 95% CI 0.13 to 0.59; p = 0.0009) were lower in the vaccinated than in unvaccinated group. Similarly, adjuvant vaccination reduced the risk of developing anal intraepithelial neoplasia (p = 0.005) and recurrent respiratory papillomatosis (p = 0.004). No differences in anogenital warts and vulvar intraepithelial neoplasia recurrence rate were observed comparing vaccinated and unvaccinated individuals. Conclusions: Adjuvant HPV vaccination is associated with a reduced risk of CIN recurrence, although there are limited data regarding its role in other HPV-related diseases. Further research is warranted to shed more light on the role of HPV vaccination as adjuvant therapy after primary treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis

et al. 2022

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“…A recent meta-analysis evaluated 7 studies with a total of 3375 patients and reported a lower rate of CIN1+ recurrence in vaccinated women (6.3% vs. 10.5%, respectively). In addition, the recurrence of CIN1+ attributed to HPV-16 or HPV-18 was also lower in vaccinated women (1.1% vs. 3.1%, respectively) [ 145 ].…”

Section: Hpv Vaccination In People Living With Hivmentioning

confidence: 99%

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

2022

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Human papillomavirus (HPV) infection is the most common sexually transmitted infection (STI) worldwide. Although most HPV infections will spontaneously resolve, a considerable proportion of them will persist, increasing the risk of anogenital dysplasia, especially within certain populations, such as patients infected with human immunodeficiency virus (HIV). Furthermore, high-risk oncogenic HPV types (HR-HPV) are the main cause of cervix and other anogenital cancers, such as cancer of the vagina, vulva, penis, or anus. HIV and HPV coinfection is common among people living with HIV (PLWH) but disproportionally affects men who have sex with men (MSM) for whom the rate of persistent HPV infection and reinfection is noteworthy. The molecular interactions between HIV and HPV, as well as the interplay between both viruses and the immune system, are increasingly being understood. The immune dysfunction induced by HIV infection impairs the rate of HPV clearance and increases its oncogenic risk. Despite the availability of effective antiretroviral therapy (ART), the incidence of several HPV-related cancers is higher in PLWH, and the burden of persistent HPV-related disease has become a significant concern in an aging HIV population. Several public health strategies have been developed to reduce the transmission of HIV and HPV and mitigate the consequences of this type of coinfection. Universal HPV vaccination is the most effective preventive tool to reduce the incidence of HPV disease. In addition, screening programs for HPV-related cervical and vulvovaginal diseases in women are well-recognized strategies to prevent cervical cancer. Similarly, anal dysplasia screening programs are being implemented worldwide for the prevention of anal cancer among PLWH. Herein, the main epidemiological features and clinical implications of HIV and HPV coinfection are reviewed, focusing mainly on the relationship between HIV immune status and HPV-related diseases and the current strategies used to reduce the burden of HPV-related disease.

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“…Oncovirus-specific T cells and epitopes have also been characterized in virus-associated tumors, such as MCPyVassociated Merkel cell carcinoma (152); HPV-associated cervical cancer (153,154) and HNSCC (155)(156)(157)(158); EBVassociated nasopharyngeal carcinoma (159,160) and gastric cancer (161); and HBV-associated hepatocellular carcinomas (139,162). Surgical removal of HPV-positive tumors followed by HPV vaccination has shown promising results to prevent cervical cancer recurrence (163,164) and the use of virus-specific T cells or T cells engineered to recognize virus-derived antigens have shown promising results in preclinical models, case reports and clinical trials in multiple cancers (165)(166)(167), suggesting that recognition of viral antigens by cells of the adaptive immune system is a crucial feature controlling the growth and therapeutic response of virus-associated cancers.…”

Section: Exogenous Viruses As Triggers Of Anti-tumor Immune Responsesmentioning

confidence: 99%

Antiviral Responses in Cancer: Boosting Antitumor Immunity Through Activation of Interferon Pathway in the Tumor Microenvironment

et al. 2021

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In recent years, it became apparent that cancers either associated with viral infections or aberrantly expressing endogenous retroviral elements (EREs) are more immunogenic, exhibiting an intense intra-tumor immune cell infiltration characterized by a robust cytolytic apparatus. On the other hand, epigenetic regulation of EREs is crucial to maintain steady-state conditions and cell homeostasis. In line with this, epigenetic disruptions within steady-state cells can lead to cancer development and trigger the release of EREs into the cytoplasmic compartment. As such, detection of viral molecules by intracellular innate immune sensors leads to the production of type I and type III interferons that act to induce an antiviral state, thus restraining viral replication. This knowledge has recently gained momentum due to the possibility of triggering intratumoral activation of interferon responses, which could be used as an adjuvant to elicit strong anti-tumor immune responses that ultimately lead to a cascade of cytokine production. Accordingly, several therapeutic approaches are currently being tested using this rationale to improve responses to cancer immunotherapies. In this review, we discuss the immune mechanisms operating in viral infections, show evidence that exogenous viruses and endogenous retroviruses in cancer may enhance tumor immunogenicity, dissect the epigenetic control of EREs, and point to interferon pathway activation in the tumor milieu as a promising molecular predictive marker and immunotherapy target. Finally, we briefly discuss current strategies to modulate these responses within tumor tissues, including the clinical use of innate immune receptor agonists and DNA demethylating agents.

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Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis

Cited by 53 publications

References 47 publications

HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis

HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

Antiviral Responses in Cancer: Boosting Antitumor Immunity Through Activation of Interferon Pathway in the Tumor Microenvironment

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