Threshold cost-effectiveness analysis for a therapeutic vaccine against HPV-16/18-positive cervical intraepithelial neoplasia in the Netherlands

Luttjeboer, Jos; Setiawan, Dedy; Cao, Qi; Daemen, Toos; Postma, Maarten J.

doi:10.1016/j.vaccine.2016.10.019

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…In order to overcome this problem, development of a therapeutic vaccine as a new treatment option without surgery is urgently needed. The availability of low-cost therapeutic vaccines for patients with CIN or stage IA CC in the future will lead to a long-term reduction in medical costs [107].…”

Section: Discussionmentioning

confidence: 99%

Secondary Prevention of Uterine Cervical Cancer

Sato¹,

Itamochi²

2018

Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

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Secondary prevention by cervical cytology has clearly improved the mortality rate of uterine cervical cancer (CC) by enabling early detection and treatment of high-grade squamous intraepithelial lesion (HSIL) or cervical intraepithelial neoplasia (CIN), which is a precancerous lesion. In the past two decades, HPV-DNA testing, including HPV typing, has clearly brought about positive effects on secondary prevention of CC. However, in practice, CC remains a fatal disease and is the second leading cause of cancer deaths in women aged 20-39 years. Although elucidation of the mechanisms of HPV carcinogenesis and development of a prophylactic vaccine have made CC a preventable disease, eradication of CC is expected to take several decades. Therefore, primary screening to decrease the mortality rate of CC will remain important for a while. In addition, the clinical application of simple biomarkers to stratify HPV-positive women is important for maintenance of medical economy and avoidance of overtreatment in women in the reproductive age. Therefore, the development of an inexpensive therapy or vaccine that can be used worldwide is necessary to overcome cancer deaths due to CC.

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Section: Discussionmentioning

confidence: 99%

Secondary Prevention of Uterine Cervical Cancer

Sato¹,

Itamochi²

2018

Cervical Cancer - Screening, Treatment and Prevention - Universal Protocols for Ultimate Control

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“…(I) Dilution of the standard substance: We added the standard substance to 10 wells of the coated microplate and then diluted the standard in series as described in the instructions. After the dilution, the loading amount per well was 50 µL and the concentrations were 180, 120, 60, 30, and 15 U/mL, respectively ( 2 ). Sample loading: Blank wells and sample wells were designed.…”

Section: Methodsmentioning

confidence: 99%

The correlation of HPV16 and HPV18 with local vaginal immunity after the treatment of cervical intraepithelial neoplasia

Mu¹,

Miao²,

Song³

2020

Transl Cancer Res TCR

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Background This study aimed to investigate the correlation between the level of HPV16 and HPV18 in patients with cervical lesions and the local vaginal immunity after receiving treatment with different degrees of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC). Methods One hundred and thirty-six patients with LSIL (grade 1 CIN or CIN 1), 263 patients with HSIL (grade 2 and 3 CIN or CIN 2 and 3), and 33 patients with CSCC pathologically confirmed between November 2012 and September 2016 were assigned to the test group and 100 healthy women in the same period were assigned to the control group. ELISA was used to determine the levels of SIgA, IgG, IL-2, and IL-10 and the IL-2/IL-10 ratio in vaginal lavage fluid in the test group (before treatment and 3, 6, and 12 months after treatment) and the control group, respectively. Gene chip technology was adopted to test the HPV infection in the test group (before treatment and 3, 6, and 12 months after treatment) and the control group, respectively. Results The results showed that the levels of SIgA, IgG, and IL-10 were positively correlated with the degree of cervical lesions and IL-2/IL-10 was negatively correlated with the degree in all patients before treatment. The levels of SIgA, IgG, and IL-10 were positively correlated with the degree of cervical lesions and IL-2/IL-10 was negatively correlated with the degree in HPV16 and HPV18-infected patients before receiving the treatment. Conclusions The recovery after the treatment of HPV infection is time-dependent and the immune system of patients with CIN starts to recover in the 6th month after treatment, early intervention is not recommended. However, the immune system is approximately in a normal sate at 12 months after treatment, at which time the efficacy can be evaluated, and clinical intervention can be initiated if necessary. The level of local immune factors in the vagina can be monitored to determine the progression and prognosis of patients’ cervical lesions.

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“…Most of the studies exhibited sufficient reporting on the selection of participants, classification of interventions, and low of risk of bias due to deviations from intended interventions. A high selection bias that arises due to exclusion of individuals with missing information about intervention status was found in four studies (10,13,15,16). Finally, the measurement of outcomes and selection of the reported result were sufficiently reported.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 98%

“…Several studies showed that the implementation of HPV vaccination as a cervical cancer prevention policy faces several issues such as coverage, acceptance, and the high price of the vaccine [13]. The reduction of cost-related vaccines will substantially influence the decision regarding implementing the policy in a country.…”

Section: Introductionmentioning

confidence: 99%

The clinical effectiveness of one-dose vaccination with an HPV vaccine: A meta-analysis of 902,368 vaccinated women

Setiawan,

Nurulita,

Khoirunnisa

et al. 2024

PLoS ONE

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Background The comprehensive effectiveness of the HPV vaccine has been widely acknowledged. However, challenges such as dosing adherence and limited budgets have led to delays in HPV vaccination implementation in many countries. A potential solution to these issues could lie in a one-dose vaccination with an HPV vaccine, as indicated by promising outcomes in multiple studies. Methods In this systematic review and meta-analysis, we examine the comparative effectiveness of the one-dose vaccination with an HPV vaccine against two- and three-dose regimens. Our investigation focuses on clinical efficacy, encompassing the prevention of HPV16, HPV18, and hrHPV infections, HSIL or ASC-H incidence, and CIN2/3 incidence. Results Our analysis suggests that a single-dose HPV vaccine may offer effectiveness on par with two- or three-dose schedules. This conclusion is drawn from its capacity to confer immunogenic protection for at least 8 years of follow-up, coupled with its ability to mitigate infections and pre-cancerous occurrences. Conclusion While our findings underscore the potential of the one-dose vaccination with an HPV vaccine, further research and prolonged study durations are necessary to establish robust evidence supporting this recommendation. As such, continued investigation will be critical for informing vaccination strategies

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Threshold cost-effectiveness analysis for a therapeutic vaccine against HPV-16/18-positive cervical intraepithelial neoplasia in the Netherlands

Cited by 6 publications

References 18 publications

Secondary Prevention of Uterine Cervical Cancer

Secondary Prevention of Uterine Cervical Cancer

The correlation of HPV16 and HPV18 with local vaginal immunity after the treatment of cervical intraepithelial neoplasia

The clinical effectiveness of one-dose vaccination with an HPV vaccine: A meta-analysis of 902,368 vaccinated women

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