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abstracts
hpv biology and implications in
gynecological malignancies
3IN FROM HYPOTHESIS TO PREVENTION IN 40 YEARS
S.K. Kjaer
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center,
Copenhagen, DENMARK
Indications of a relationship between cervical cancer and sexual activity have been
available for over a century. Early studies described sexual variables mainly in terms of
marital status, age at first marriage and reproductive life, whereas more recent
epidemiological studies have assessed the role of sexual habits and specifically
identified the number of sexual partners and age at first intercourse as the most
important risk factors. The finding of an independent effect of the number of sexual
partners, and the increased risk for women whose husbands reported multiple sexual
partners strongly pointed to the importance of a sexually transmitted infectious agent,
although other factors such as smoking, parity and oral contraceptive use were also
suggested to be important. For more than two decades, attention focused on herpes
simplex virus type 2 as an etiological agent. However, subsequently it was suggested by
Professor zur Hausen that certain types of human papillomavirus (HPV) might play a
key etiological role. Although there at that time was laboratory evidence supporting
this hypothesis, it was initially difficult to test it epidemiologically. With the
technological development and the collaboration between epidemiologists, virologists
and clinicians it became increasingly clear that HPV is a necessary factor in the
development of cervical cancer and also is causing a proportion of other anogenital
cancers in both women and men such as cancer of the vagina, vulva, penis and anus.
In addition, it is associated with certain types of head and neck cancer. Based on the
research within this area, vaccines against certain types of HPV have now been
developed and we have moved from hypothesis to prevention in some 40 years.
Disclosure: S.K. Kjaer: Received lecture fees, advisory board fees, and research grants
through her institution from Merck and Sanofi Pasteur MSD.
Annals of Oncology 23 (Supplement 9): ix22, 2012
doi:10.1093/annonc/mds367
4IN IMMUNE BIOLOGY OF HUMAN PAPILLOMAVIRUSES:
IMPLICATIONS FOR VACCINE DEVELOPMENT
L. Gissmann
Division of Genome Modifications and Carcinogenesis, Gerrman Cancer
Research Center, Heidelberg, GERMANY
The “high-risk” types of human papillomaviruses (HPV), in particular PV 16 and 18
are responsible for the development of almost all cases of cervical cancer, for a
substantial fraction of other malignant anogenital tumors (penis, vulva and
perianum) and for a proportion of head and neck cancer. The natural history of
HPV infections and immunization experiments in animals with their respective
papillomaviruses (e.g. the canine oral papillomavirus) clearly revealed the
involvement of the immune system in controlling the viral infections and the
diseases associated therewith. Antibodies appear to be the key molecules in
preventing of an infection whereas mostly T cells and cytokines are involved in
controlling virus persistence and progression towards malignancy.
During the natural course of infection human papillomaviruses are not particularly
immunogenic since their biology makes them barely “visible” by the immune system
(infection is confined to the epithelium) but also since it has acquired the ability to
actively suppress certain immune functions. This is in remarkable contrast to the
strong immune response induced by i.m. immunization with virus particles when
they become exposed to and interact directly with circulating antigen presenting cells.
There is mounting awareness about the mechanisms of these interactions.
Disclosure: Lutz Gissmann is a consultant to GlaxoSmithKline and Sanofi Pasteur
MSD and, due to existing intellectual property, receives royalties from sales of
Gardasil® and Cervarix®
© European Society for Medical Oncology 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
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