Gardasil - Preventing cervical cancer and other diseases related to HPV

Human papillomavirus (HPV) is absolutely required for the development and progression of precancerous lesions in the cervical epithelium, and has been isolated in more than 99% of cervical cancers sampled. Given that the majority (∼70%) of cases of cervical cancer are caused by only two HPV types, appropriately designed vaccines are an attractive proposition for preventing HPV infection and thus, by extension, cervical cancer. Gardasil is a recombinant quadrivalent HPV vaccine comprising a mixture of highly purified virus-like particles (VLPs) of the major capsid protein (L1) derived from HPV types 6, 11, 16 and 18. Gardasil prevents persistent infection by the vaccine HPV types for at least 5 years. More pertinently, in HPV-naïve women, Gardasil provides complete protection against high-grade cervical dysplasia. The vaccine also prevents vulval precancers, reduces the incidence of vaginal precancerous lesions and protects against genital warts caused by the vaccine HPV types. The vaccine stimulates a robust immune response, with serum anti-HPV antibody titres substantially higher than those associated with a natural HPV infection, whilst immune responses in children are non-inferior to those of older adolescents and young women, suggesting that Gardasil also prevents HPV infection in this population. Gardasil is well tolerated with a favourable safety profile. In summary the introduction of Gardasil in conjunction with cervical screening has the potential to substantially reduce the burden of cervical cancer and other HPV-related diseases.