The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis
Cervical cancer (CC) is a disease that affects many women worldwide, especially in low-income countries. The human papilloma virus (HPV) is the main causative agent of this disease, with the E6 and E7 oncoproteins being responsible for the development and maintenance of transformed status. In additi...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
|
| Series: | Vaccines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-393X/10/9/1560 |
| _version_ | 1797481560567447552 |
|---|---|
| author | Cathy Ventura Ângelo Luís Christiane P. Soares Aldo Venuti Francesca Paolini Luísa Pereira Ângela Sousa |
| author_facet | Cathy Ventura Ângelo Luís Christiane P. Soares Aldo Venuti Francesca Paolini Luísa Pereira Ângela Sousa |
| author_sort | Cathy Ventura |
| collection | DOAJ |
| description | Cervical cancer (CC) is a disease that affects many women worldwide, especially in low-income countries. The human papilloma virus (HPV) is the main causative agent of this disease, with the E6 and E7 oncoproteins being responsible for the development and maintenance of transformed status. In addition, HPV is also responsible for the appearance of cervical intraepithelial neoplasia (CIN), a pre-neoplastic condition burdened by very high costs for its screening and therapy. So far, only prophylactic vaccines have been approved by regulatory agencies as a means of CC prevention. However, these vaccines cannot treat HPV-positive women. A search was conducted in several databases (PubMed, Scopus, Web of Science, and ClinicalTrials.gov) to systematically identify clinical trials involving therapeutic vaccines against CIN 3. Histopathological regression data, immunological parameters, safety, DNA clearance, and vaccine efficacy were considered from each selected study, and from the 102 articles found, 8 were selected based on the defined inclusion criteria. Histopathological regression from CIN 3 to CIN < 1 was 22.1% (95% CI: 0.627–0.967; <i>p</i>-value = 0.024), showing a vaccine efficacy of 23.6% (95% CI; 0.666–0.876; <i>p</i>-value < 0.001). DNA clearance was assessed, and the risk of persistent HPV DNA was 23.2% (95% CI: 0.667–0.885; <i>p</i>-value < 0.001). Regarding immunological parameters, immune responses by specific T-HPV cells were more likely in vaccinated women (95% CI: 1.245–9.162; <i>p</i>-value = 0.017). In short, these studies favored the vaccine group over the placebo group. This work indicated that therapeutic vaccines are efficient in the treatment of CIN 3, even after accounting for publication bias. |
| first_indexed | 2024-03-09T22:16:22Z |
| format | Article |
| id | doaj.art-8401109d9c504dbc98b1f85c24ab3b38 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-09T22:16:22Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-8401109d9c504dbc98b1f85c24ab3b382023-11-23T19:23:13ZengMDPI AGVaccines2076-393X2022-09-01109156010.3390/vaccines10091560The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-AnalysisCathy Ventura0Ângelo Luís1Christiane P. Soares2Aldo Venuti3Francesca Paolini4Luísa Pereira5Ângela Sousa6CICS-UBI–Health Science Research Centre, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, PortugalCICS-UBI–Health Science Research Centre, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, PortugalDepartment of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Campus Ville, Araraquara 14800-903, SP, BrazilHPV-UNIT-UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyHPV-UNIT-UOSD Tumor Immunology and Immunotherapy, IRCCS Regina Elena National Cancer Institute, 00144 Rome, ItalyGrupo de Revisões Sistemáticas (GRUBI), Faculdade de Ciências da Saúde, Universidade da Beira Interior, 6200-506 Covilhã, PortugalCICS-UBI–Health Science Research Centre, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, PortugalCervical cancer (CC) is a disease that affects many women worldwide, especially in low-income countries. The human papilloma virus (HPV) is the main causative agent of this disease, with the E6 and E7 oncoproteins being responsible for the development and maintenance of transformed status. In addition, HPV is also responsible for the appearance of cervical intraepithelial neoplasia (CIN), a pre-neoplastic condition burdened by very high costs for its screening and therapy. So far, only prophylactic vaccines have been approved by regulatory agencies as a means of CC prevention. However, these vaccines cannot treat HPV-positive women. A search was conducted in several databases (PubMed, Scopus, Web of Science, and ClinicalTrials.gov) to systematically identify clinical trials involving therapeutic vaccines against CIN 3. Histopathological regression data, immunological parameters, safety, DNA clearance, and vaccine efficacy were considered from each selected study, and from the 102 articles found, 8 were selected based on the defined inclusion criteria. Histopathological regression from CIN 3 to CIN < 1 was 22.1% (95% CI: 0.627–0.967; <i>p</i>-value = 0.024), showing a vaccine efficacy of 23.6% (95% CI; 0.666–0.876; <i>p</i>-value < 0.001). DNA clearance was assessed, and the risk of persistent HPV DNA was 23.2% (95% CI: 0.667–0.885; <i>p</i>-value < 0.001). Regarding immunological parameters, immune responses by specific T-HPV cells were more likely in vaccinated women (95% CI: 1.245–9.162; <i>p</i>-value = 0.017). In short, these studies favored the vaccine group over the placebo group. This work indicated that therapeutic vaccines are efficient in the treatment of CIN 3, even after accounting for publication bias.https://www.mdpi.com/2076-393X/10/9/1560cervical cancerclinical trialsmeta-analysissystematic reviewtherapeutics vaccines |
| spellingShingle | Cathy Ventura Ângelo Luís Christiane P. Soares Aldo Venuti Francesca Paolini Luísa Pereira Ângela Sousa The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis Vaccines cervical cancer clinical trials meta-analysis systematic review therapeutics vaccines |
| title | The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis |
| title_full | The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis |
| title_fullStr | The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis |
| title_short | The Effectiveness of Therapeutic Vaccines for the Treatment of Cervical Intraepithelial Neoplasia 3: A Systematic Review and Meta-Analysis |
| title_sort | effectiveness of therapeutic vaccines for the treatment of cervical intraepithelial neoplasia 3 a systematic review and meta analysis |
| topic | cervical cancer clinical trials meta-analysis systematic review therapeutics vaccines |
| url | https://www.mdpi.com/2076-393X/10/9/1560 |
| work_keys_str_mv | AT cathyventura theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT angeloluis theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT christianepsoares theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT aldovenuti theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT francescapaolini theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT luisapereira theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT angelasousa theeffectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT cathyventura effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT angeloluis effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT christianepsoares effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT aldovenuti effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT francescapaolini effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT luisapereira effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis AT angelasousa effectivenessoftherapeuticvaccinesforthetreatmentofcervicalintraepithelialneoplasia3asystematicreviewandmetaanalysis |