Expert Point of View: Heather L. McArthur, MD, MPH

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Heather L. McArthur, MD, MPH

Heather L. McArthur, MD, MPH

Study discussant Heather L. McArthur, MD, MPH, Medical Director of Breast Oncology at Cedars-Sinai Medical Center, Los Angeles, noted that human papillomavirus (HPV) vaccination has been shown to prevent HPV-related malignancies and eradicate high-grade, HPV16-positive premalignant lesions. However, its role in the treatment of invasive cancers has not yet been defined.

Impressive Waterfall Plot

The CervISA results suggest a role for therapeutic vaccination, according to Dr. McArthur, who called the findings “exciting.” “This is one of the most impressive waterfall plots that I’ve ever seen with responses observed across each of the four evaluated doses. Although prospectively collected, randomized data will be needed to determine the magnitude of the clinical impact of therapeutic vaccination, it is reasonable to expect that with response rates like these, vaccines could become a standard of care for the treatment of HPV-related cervical cancer in the not-too-distant future,” she said.

The fact that HPV-specific responses were so important in determining survival after vaccination, regardless of general immune status, “suggests that it’s not so much about the number of players on the field, but rather it’s the quality and focus of the available players that are critically important,” she added.

Dr. McArthur said she would like to know more about the baseline characteristics of the patients and specifically what percentage had received HPV vaccination. “Could HPV vaccine prophylaxis in youth prime the immune system for greater response to therapeutic HPV vaccination,” she queried.

“Overall,” she concluded, “These are provocative and promising data.” ■

Disclosure: Dr. McArthur is on advisory boards for Celgene, Merck, OBI Pharma, Spectrum Pharmaceuticals, Syndax Pharmaceuticals, Roche, Peregrine, and Calithera. Her current research is supported by Bristol-Myers Squibb, Eli Lilly, MedImmunne, LLC/AstraZeneca, and Merck.

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We have now completed a chemoimmunotherapy study in a larger number of patients with late-stage HPV16-positive cervical cancer, and we have shown that in these patients, the combination is worthwhile.
— Marij Welters, PhD

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