Immunotherapy for the treatment of penile intraepithelial neoplasia associated with human papilloma virus type 16 using topical imiquimod and human papilloma virus vaccination

Abstract

Penile intraepithelial neoplasia (PeIN) is frequently associated with human papilloma virus (HPV). Three cases of PeIN associated with HPV-type 16 were successfully treated with topical imiquimod and concurrent HPV vaccination. Human papilloma vaccine protects against oncogenic human papilloma viruses. In New Zealand, a decline in incidence of PeIN is anticipated with the recent funding of human papilloma vaccine for boys and young men aged 9-26 years. Therefore, HPV vaccination may have a role for treatment of PeIN and prophylaxis.

Unveiling the Therapeutic Horizon: HPV Vaccines and Their Impact on Cutaneous Diseases—A Comprehensive Review

“…In contrast, at a 13-month follow-up, the female patient experienced a decline to 1.84 SCCs and 0 BCCs per year (a 66.5% reduction in SCCs and a 100% reduction in BCCs) [7,83]. Remarkable outcomes were also observed in the three studies we identified during our search, specifically in relation to penile cancer, Bowen's disease, and cutaneous basaloid SCCs [28][29][30].…”

“…Subsequent follow-up biopsies, conducted at intervals exceeding nine months, revealed no indications of persistent penile intraepithelial neoplasia. Additionally, immunostaining for HPV 16 yielded negative results [ 29 ]. An intriguing paper outlines the case of a 90-year-old woman presenting with multiple cutaneous basaloid squamous cell carcinomas (SCCs).…”

“…Interestingly, this unintended form of excessive immunization did not result in improved clearance outcomes. Furthermore, in one of the studies, these patients exhibited significantly lower verruca vulgaris resolution ( p = 0.006) [ 29 , 66 ]. An intriguing observation is that the bHPV vaccine demonstrated statistically significant greater efficacy on larger-sized warts [ 42 ].…”

Human Papillomavirus Infection in Penile Cancer: Multidimensional Mechanisms and Vaccine Strategies

“…Strong activation of CD4 + T h and CD8 + T lymphocytes against the HPV vaccine was detected, and dose-dependent responses with HLA-DR, a marker of T cell activation, were observed against gardasil at 0.1, 0.3, and 1.0 µg/mL, supporting T cell stimulation depending on the HPV vaccine [116]. In addition, another brief report presented an immunologic response and satisfactory efficacy against penile intraepithelial neoplasia using the HPV vaccine in combination with imiquimod, exhibiting a synergistic immunomodulatory effect on lesion clearance in the penis [135]. However, therapeutic HPV vaccines for PC are still in the preclinical stage and more research is needed on vaccine strategies for PC treatment.…”