<p>Recombinant human papillomavirus nonavalent vaccine in the prevention of cancers caused by human papillomavirus</p>

Abstract

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.

HPV-Specific Systemic Antibody Responses and Memory B Cells are Independently Maintained up to 6 Years and in a Vaccine-Specific Manner Following Immunization with Cervarix and Gardasil in Adolescent and Young Adult Women in Vaccination Programs in Italy

“…Prophylactic HPV vaccines in widespread use since 2006/2007 [7,8] include the AS04-adjuvanted bivalent vaccine (2vHPV; Cervarix, GSK, Verona, Italy) and the aluminium hydroxyphosphate sulfate salt-adjuvanted quadrivalent vaccine (4vHPV; Gardasil, Merck, Rome, Italy) [9], which also exhibit some degree of cross-protection against non-vaccine high-risk HPV types 31, 33, and 45 [10][11][12]. Further, in 2014, a nonavalent vaccine (9vHPV; Gardasil 9, Merck) has been licensed by the FDA and then approved in several countries [13]. Although manufactured by different methods, in insects (Cervarix) and yeasts (Gardasil), all of the vaccines are formulated as virus-like particles (VLPs) of recombinant L1 capsid proteins of oncogenic HPV-16 and HPV-18.…”

“…All of the vaccines indeed elicit high titres of potent, type-specific nAbs that prevent infection by transudation or exudation through the epithelium at the site of infection [8,18,19] and induce protection against cervical cancer that is associated to the vaccine HPV with approximately 100% efficacy [20][21][22][23]. Indeed, follow up studies report long-term immune responses and protection up to 10-12 years for Cervarix and Gardasil [24][25][26] and up to five years for Gardasil 9 [13,27]. However, continued monitoring is important in identifying potential signals of waning, especially in women that are vaccinated after adolescence.…”

Progress in Vaccination of Prophylactic Human Papillomavirus Vaccine

“…When this group was revaccinated again with one dose of 9vHPV, the antibody responses were higher at the first week and the first month after the fourth dose. This indicates that after three doses of the primary series of vaccines, the immune memory of all nine HPV types was affected (7). Compared with 4vHPV and 9vHPV vaccine, the 2vHPV vaccine has higher immunogenicity that elicits more HPV16/18 antibodies and stronger CD4+ T cell responses.…”

“…In 2007, 4vHPV, and 2vHPV were licensed (Figure 1). In 2014, 9vHPV was licensed (7). Currently, vaccination can reduce the incidence of female and male reproductive tract diseases has been determined, including anal and oral HPV infection and cervical, vaginal, vulvar, penile, and anal intraepithelial neoplasia (4).…”

Prevalence of Oncogenic Human Papillomavirus Genotypes Among Sexually Active Women in Parakou (Benin, West Africa)

“…The prophylactic nonavaccine licensed in 2014, only available in certain regions, target genotypes 6 and 11 which are the cause of benign genital lesions and the next five most common cancer-causing HPV types (HPV 31/33/45/52/58) after HPV 16/18, thus enabling a primary prevention [9]. The genotypes targeted by those vaccines sometimes are not the most encountered in some African regions.…”