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@ARTICLE{Dull:291649,
author = {P. M. Dull and S. L. Achilles and R. Ahmed and R. V.
Barnabas and N. G. Campos and K. Chirgwin and J. A. Cohen
and S. de Sanjosé and J. Doorbar and M. H. Einstein and C.
I. Emerson and S. L. Gottlieb and A. Hildesheim and Y. Qiao
and P. Ruff and J. N. Sampson and P. Sasieni and M.
Schiffman and H. Shin and M. A. Stanley and C. L. Trimble
and N. Wentzensen and A. Riemer$^*$ and J. T. Schiller and
A. R. Kreimer},
title = {{M}eeting report: {C}onsiderations for trial design and
endpoints in licensing therapeutic {HPV}16/18 vaccines to
prevent cervical cancer.},
journal = {Vaccine},
volume = {42},
number = {25},
issn = {0264-410X},
address = {Amsterdam},
publisher = {Elsevier},
reportid = {DKFZ-2024-01473},
pages = {126100},
year = {2024},
note = {2024 Nov 14;42(25):126100 / Conference report / #LA:D410#},
abstract = {Cervical cancer is a major cause of morbidity and mortality
globally with a disproportionate impact on women in low- and
middle-income countries. In 2021, the World Health
Organization (WHO) called for increased vaccination,
screening, and treatment to eliminate cervical cancer.
However, even with widespread rollout of human
papillomavirus (HPV) prophylactic vaccines, millions of
women who previously acquired HPV infections will remain at
risk for progression to cancer for decades to come. The
development and licensing of an affordable, accessible
therapeutic HPV vaccine, designed to clear or control
carcinogenic HPV and/or to induce regression precancer could
significantly contribute to the elimination efforts,
particularly benefiting those who missed out on the
prophylactic vaccine. One barrier to development of such
vaccines is clarity around the regulatory pathway for
licensure. In Washington, D.C. on September 12-13, 2023, a
meeting was convened to provide input and guidance on trial
design with associated ethical and regulatory
considerations. This report summarizes the discussion and
conclusions from the meeting. Expert presentation topics
included the current state of research, potential regulatory
challenges, WHO preferred product characteristics, modeling
results of impact of vaccine implementation, epidemiology
and natural history of HPV infection, immune responses
related to viral clearance and/or precancer regression
including potential biomarkers, and ethical considerations.
Panel discussions were held to explore specific trial design
recommendations to support the licensure process for two
vaccine indications: (1) treatment of prevalent HPV
infection or (2) treatment of cervical precancers.
Discussion covered inclusion/exclusion criteria, study
endpoints, sample size and power, safety, study length, and
additional data needed, which are reported here. Further
research of HPV natural history is needed to address
identified gaps in regulatory guidance, especially for
therapeutic vaccines intended to treat existing HPV
infections.},
keywords = {Cervical cancer (Other) / HPV (Other) / HPV therapeutic
vaccine (Other) / Human papillomavirus (Other)},
cin = {D410},
ddc = {610},
cid = {I:(DE-He78)D410-20160331},
pnm = {314 - Immunologie und Krebs (POF4-314)},
pid = {G:(DE-HGF)POF4-314},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39004526},
doi = {10.1016/j.vaccine.2024.07.001},
url = {https://inrepo02.dkfz.de/record/291649},
}