Cervical carcinoma and several other human papillomavirus (HPV)-induced malignancies are a global public health problem, thus novel treatment modalities are urgently needed. Immunotherapy is an attractive option for treatment of HPV infection and HPV-mediated premalignant and malignant lesions. However, previous approaches-focusing on the induction of cytotoxic CD81 T cells (CTLs)-have as yet not yielded clinical successes. Since CD41 T cells have been shown to be crucial for the induction and maintenance of CTL responses, and more recently to be also important for direct anti-tumor immunity, human leukocyte antigen (HLA) class II-restricted epitopes are intensively investigated to improve the efficacy of peptide-based HPV immunotherapy. We here present an approach to identify promiscuous HPV16-derived CD41 T helper epitopes, which are capable of inducing T cell immunity in a large proportion of the population. To this end, we combined HLA class II epitope prediction servers with in vitro immunological evaluation to identify HPV16 E2-, E5-, E6-, and E7-derived CD41 T cell epitopes. Candidate selected HPV16-derived epitopes were found to be restricted by up to nine HLA-DR molecules. Furthermore, they were found to induce frequent and robust HPV16 peptide-specific Th1 responses in healthy donors, as monitored by interferon (IFN)-c ELISPOT and cytokine secretion assays. Moreover, these selected peptides also induced specific IFN-c T cell responses in blood from HPV161 CIN2/3 and cervical carcinoma patients. We thus conclude that the identified T helper epitopes are valuable candidates for the development of a comprehensive therapeutic HPV vaccine.High-risk types of human papillomavirus (HPV) are associated with several malignant diseases, including cervical carcinoma (CxCa), other anogenital tumors and oropharyngeal carcinomas. 1-3 Natural history studies indicate that nearly every sexually active individual will acquire at least one highrisk HPV infection during their lifetime. 4,5 Fortunately, the majority of HPV infections are eradicated by the host immune system within 1-2 years of acquisition, 6,7 and only <1% of infected people develop HPV-mediated cancers. 8,9 Why some individuals clear the viral infection, while others do not, is still incompletely understood. Accumulating data suggest that both cytotoxic CD81 T cell (CTL) and CD41 T helper (Th) cell responses play a pivotal role in the control and clearance of HPV infection. [10][11][12][13] To date, however, the majority of therapeutic HPV vaccines have been designed to elicit tumor-specific CTL responses. 14-16 Unfortunately, only disappointing clinical outcomes have been observed, with the exception of one study with synthetic long peptides in vulvar intraepithelial neoplasia. 17 Exclusive targeting of HLA (human leukocyte antigen) class I-restricted CTL HPV epitopes, without involving specific T-cell help, can lead to suboptimal and short-lasting CD81 T cell responses. The lessons learned from these clinical studies lead to a rethinking of therapeutic ...