The world's first vaccine designed to prevent cancer was not developed by a pharmaceutical company. Instead, its development was funded by public institutions on two continents, including three universities, and the U.S. National Cancer Institute. The vaccine prevents human papillomavirus (HPV), an ailment that can lead to deadly cervical cancer. HPV is spread through sexual contact, and 80% of males and females become infected during their lifetimes. But, thanks the to HPV vaccine, it doesn't have to be that way anymore.
How the HPV vaccine works
The HPV vaccine relies on virus-like particles (VLPs). The VLPs in the HPV vaccine share the same outer protein coat (L1) as human papillomavirus, however, the VLPs do lack the genetic material in HPV necessary to infect a human. The outer protein coat is the key to how the vaccine works. Thanks to the protein coat, the VLPs can assemble in the same way as HPV, and this structural similarity allows the components of the vaccine to produce an immune response without subjecting the patient to the virus in any way. It's not a neutered or dead form of the virus as in the influenza vaccine - it's no virus at all.
3 schools, 4 research groups, & (at least) 4 patents
The creation of the HPV vaccine was an effort two decades in the making. Researchers at Georgetown University are credited with the dominant patent for the the HPV vaccine due to their initial background research, however, the Georgetown team never worked with the virus-like particles. The Georgetown University group showed that the native conformation (the normal form) of L1 protein coat was needed to allow virus-like particles to form.
The U.S. Patent Office also recognizes patent claims from the U.S. National Cancer Institute, the University of Queensland, and the University of Rochester. Researchers at the University of Queensland published data with two different types of protein coats, L1 and L2, and noted that these coats allowed the assembly of virus like particles, but these virus like particles were small and not correctly assembled. This finding pre-dated the Georgetown University publication, and has spurred some controversy concerning the dominant patent.
Researchers at the National Cancer Institute, a branch of the NIH separate and apart from universities, were the first to produce an active virus-like particle that produced an immune response in animals. The NCI researchers also determined that other researchers had been using a mutant of the major HPV L1 capsid, causing slight changes in the manner in which the VLPs formed, thus refining the process.
The University of Rochester team was responsible for the first studies showing an immune response in humans. The University of Queensland research was pioneered by Dr. Ian Frazer in Australia, and sold partial patents to Merck and an Australian company CSL Limited to finance their research and clinical trials. The teams at Georgetown University and the University of Rochester were funded through grants from the National Cancer Institute.
These four groups may not have worked jointly, however, their work (and possible academic rivalry) combined with public funding allowed for quick and efficient discovery and optimization of the VLPs, as most of the major research findings paving the way for the HPV vaccine occurred between 1991 and 1993.
Two versions of the vaccine
Gardisil, the first HPV vaccine on the market, is manufactured by Merck and protects against four different strains of HPV. This protection covers HPV-16 and HPV-18, with these causing 70% of cervical cancer cases, cases which kill as many as 300,000 women annually. HPV-16 has also been linked to oropharyngeal cancer. Gardisil also protects against HPV-6 and HPV-11, guarding against 90% of genital warts. Protection against general warts and a recent FDA statement showing Gardisil to prevent anal and oropharyngeal cancer has increased demand amongst both males and females.
Cervarix, produced by GlaxosmithKline and approved for use in the United States in 2009 after several years of use in other areas of the world, protects only against HPV-16 and HPV-18, and thus lacks protection against genital warts. Despite this lack of protection against the physical attributes of sexually transmitted disease, one recent National Cancer Institute study showed that two of the mandated three shots of Cervarix may be sufficient for protection. This is quite the finding, as the third dose is taken six months after the initial injection, and likely to be skipped by the patient. Additionally, Cevarix has been shown to be effective over 7 years after administration.
Arguing against the HPV Vaccine
The suggestion that boys and young men receive the HPV vaccine has been met with controversy. Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine, recently stated his support for administering the vaccine to boys and young men, emphasizing how far basic research has come:
This is cancer, for Pete's sake […] A vaccine against cancer was the dream of our youth.
You might not like shots, but it's hard to argue against getting the HPV vaccine. There is no dead or neutered virus involved - there is no genetic material in the vaccine at all. The HPV vaccine a great example of public funding and several universities putting the parts together quickly and saving many lives in the process.
Images courtesy of the World Health Organization, Medscape, and GlaxoSmithKline. Sources linked within article.