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Cancer Vaccines: Targeting an Infectious Cause

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Science Translational Medicine  16 Jan 2013:
Vol. 5, Issue 168, pp. 168ec11
DOI: 10.1126/scitranslmed.3005665

Infectious agents, such as viruses, can be noxious stimuli and induce cancer growth in much the same way as tobacco or radiation does—by provoking the abnormal growth of cells. However, for some cancers, infection directy leads to cancer development: In cervical cancer, for example, the human papillomavirus (HPV) causes approximately 100% of cancers. For other cancers, such as anal cancer, a smaller percentage of cancers may be caused by infections, whereas the remainder could be caused by other noxious stimuli or arise spontaneously. Thus, it is important to estimate the percentage of cancers attributable to infectious agents so that vaccines can be developed to prevent infections and consequently prevent disease, including cancer.

Two recent papers estimated the fraction of anal and laryngeal cancer caused by HPV. Anal cancer incidence is increasing among men who have sex with men (MSM), particularly those living with HIV, despite antiretroviral therapy. Sahasrabuddhe and colleagues followed 363 HIV-positive MSM and estimated the proportion of precancerous lesions attributable to HPV. They estimated that the HPV vaccine in development, which would protect against 7 HPV types, could prevent 39 to 89% of precancerous anal lesions, whereas the existing HPV vaccine could protect against 12 to 62% of precancerous lesions.

Laryngeal cancer is the sixth most common cancer globally. Li and colleagues systematically reviewed studies on HPV infection and laryngeal cancer. In summarizing the data from 55 studies, they found that HPV virus was detectable in 28% of laryngeal cancers. The two most common HPV types, 16 and 18, are covered by existing HPV vaccines and represent 20 and 6% of laryngeal cancers, respectively.

Infectious agents cause 18% of the world’s cancer cases annually. Vaccination to prevent infections and prompt diagnosis and treatment could serve to avert these cases. As our understanding of the role of infectious diseases in cancer grows, development of new prevention tools, such as vaccines, will aid the fight against cancer in addition to preventing infectious diseases.

V. V. Sahasrabuddhe et al., Human papillomavirus genotype attribution and estimation of preventable fraction of anal intraepithelial neoplasia cases among HIV-infected men who have sex with men. J. Infect. Dis. 207, 392–401 (2013).[ABSTRACT]

X. Li et al., Human papillomavirus infection and laryngeal cancer risk: A systematic review and meta-analysis. J. Infect. Dis. 207, 479–488 (2013). [ABSTRACT]

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