23
Volume3 Issue5
|
I
ssues and
P
eople
CanHPVVaccines Prevent
OropharyngealCancer?
Dr.AnnaR.Giuliano is aprofessoranddirectorof theCenter for InfectionResearch inCancerat theMoffittCancerCenter in
Tampa, Florida.Her research focuses onHPV-related carcinogenesis, includingheadandneck cancers. She gaveapresentation
at aPan-AmericanHealthOrganization (PAHO) consultationmeetingonHPV-associatedoropharyngeal cancer in July2015.
CDA talked toDr.Giuliano to learnmoreabout the current state of knowledge regarding the efficacyof vaccines inpreventing
HPV-relatedoropharyngeal cancer.
Givenhow
important this
vaccine is in
preventing so
many of the other
HPV-related
diseases, I think it’s
quite appropriate
to give a strong
recommendation for
vaccination of the
target population.
Canyou talkaboutyour lectureat the
PAHOconsultationmeeting?
Iwas asked todoa summaryof the studies
that have shown theefficacyofHPV
vaccines for preventing relateddiseases
inboth females andmales. Iwas able to
show that there is avery strongprevention
efficacyagainst cervical, vulvar andvaginal
cancers in females. TheoneHPVvaccine
trial conductedamongmales showedvery
strongefficacyagainst the infectionaswell
as the lesions thatHPVcauses at thegenitals
andanal canal inyoungmen.
Howeffectivearevaccines inpreventing
HPV-associatedoropharyngeal cancer?
Let’s startwith thedatawedohave.
Amongmales and females, theprevention
of anal-genital infections and related
cancers isnearly100% ifwevaccinateat a
youngageamong individualswhohave
never beenexposed to thevirus. So it’s
incrediblyeffective inpreventingHPV-
relateddiseases inbothmenandwomen.
However, thevaccinehasnever been tested
ina trial designed toevaluatewhether the
vaccinewill prevent oral HPV infectionsor
oropharyngeal cancer. So this remains an
unansweredquestion.
Is thereamessage thatdentistsshould
begiving to theirat-riskpatients?
Thevaccines areapproved for use in the
UnitedStates and inCanada the sameway:
for vaccinationof youngadolescents, 11and
12yearsof age,withacatch-updepending
onwhereyouare in theAmericasof up to
age26 for bothmales and females.
I think themessagedentists cangive to
families, aswell as toyoungadults, ishow
effective thevaccine is inpreventingHPV
infection.Wedon’t have theevidence
tomakea statement directlyabout the
preventionof oropharyngeal cancer, but
givenhow important this vaccine is in
preventing somanyof theotherHPV-related
diseases, I think it’squiteappropriate togive
a strong recommendation for vaccinationof
the target population.
Whatwere the recommendations that
cameoutof theconsultationmeeting?
Theoral healthproviderswhoattended
themeeting felt very strongly thatwithout
definitiveevidence, theycouldnot draft a
policy statement or recommendation to
vaccinate toprevent oropharyngeal cancer.
They felt that there is a tremendousneed
for a trial tobeconducted todefinitely
provide theevidence, inwhichcase
recommendations andpolicy statements
couldbemadeby thevarioushealth
authorities.
Anyfinal thoughts fordentists?
I feel verypositive that ifwecanconduct this
phase-3 trial to test theefficacyagainst these
oropharyngeal lesions,wewill likely see that
thevaccineswork. But untilweconduct the
trial,we’re ina standstill. So researchmust
continue. I’d say thatwithinadecadewe’ll
have the informationweneed tocover all of
thesecancers.
a
Watch the
full interviewwith
Dr. AnnaGiulianoat
