HPV vaccination rates have increased in the US
The uptake of HPV vaccines in US adolescents was 60% in 2016, which is a 4 percentage point increase from the previous year. According to the Centers for Disease Control and Prevention (CDC), 65% of girls and 56% of boys received at least one dose, but only 43% overall completed the recommended schedule, which includes two and three injections for subjects aged ≤15 and >15, respectively.
At the same time, a study from Utah found that HPV vaccine awareness and uptake were 60% and 50% lower, respectively, in religious women compared to those who did not practice religion.1 Utah is among US states with lowest HPV vaccination rates.
1. Bodson J, Wilson A, Warner EL, Kepka D. Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18–26 in Utah. PLOS One 2017; 12(8):e0183725
First CAR-T cell therapy of cancer was approved by FDA
The US Food and Drug Administration (FDA) has approved tisagenlecleucel (Kymriah, Novartis) for recurrent B-cell acute lymphoblastic leukemia in people aged 25 years and younger. Tisagenlecleucel thus becomes the first approved chimeric antigen receptor T-cell (CAR-T) therapy, in which patients’ own immune cells are harvested and genetically engineered to target a cancer epitope, in this case the B-cell surface antigen CD19.
Another success of CAR-T treatment was reported by researchers at Massachusetts General Hospital.1 A patient with chemotherapy-resistant diffuse large-B-cell lymphoma, which had metastasized into the brain, experienced a complete remission of the tumor in the central nervous system following CAR-T therapy.
1. Abramson JS, McGree B, Noyes S, Plummer S, Wong C, Chen YB, Palmer E, Albertson T, Ferry JA, Arrillaga-Romany IC. Anti-CD19 CAR T Cells in CNS Diffuse Large-B-Cell Lymphoma. N Engl J Med. 2017; 377(8):783-784
Routine rotavirus vaccination continues to reduce diarrhea and save medical costs in the US
Almost 400,000 US children avoided hospitalization due to acute gastroenteritis following the introduction of routine rotavirus vaccination, saving >$1 billion in medical costs.1 According to the study, which analyzed hospital data in 26 states during 2008–13, hospitalizations continued to decrease, reaching a 55% decline in more recent years compared to the pre-vaccination era. The impact of the rotavirus vaccine is likely even greater, because the study did not take into account avoided general practitioner and emergency room visits.
“Our findings confirm the sustained impact and effectiveness of the rotavirus vaccine program,” lead author Eyal Leshem of CDC said. “Increasing vaccine coverage likely resulted in the larger declines of rotavirus hospitalizations observed in the later years studied.”
1. Leshem E, Tate JE, Steiner CA, Curns AT, Lopman BA, Parashar UD. National Estimates of Reductions in Acute Gastroenteritis–Related Hospitalizations and Associated Costs in US Children After Implementation of Rotavirus Vaccines. J Ped Infect Dis Soc 2017; doi:10.1093/jpids/pix057
Novel technology for immunotherapeutic MAb delivery tested in mice
Treatment with DNA for MAb delivery successfully shrank tumors and increased survival in a preclinical model of prostate cancer.1 The method utilizes a plasmid encoding a MAb that recognizes the prostate-specific membrane antigen (PSMA). The MAb is expressed in vivo and elicits anti-tumor immune response.
“This is an important demonstration of the possibilities opened up for immunotherapy by DMAb technology to direct in-vivo production of antibodies of major relevance to human cancer,” senior author David Weiner of Wistar Institute said. “There is a great need for such new approaches for prostate disease as well as many other cancers. As recent data suggest, PSMA is an important cancer antigen expressed on many human prostate, bladder, renal as well as ovarian cancers, so additional study of the possible benefits of this therapy are important.”
1. Muthumani K, Marnin L, Kudchodkar SB, Perales-Puchalt A, Choi H, Agarwal S, Scott VL, Reuschel EL, Zaidi FI, Duperret EK, Wise MC, Kraynyak KA, Ugen KE, Sardesai NY, Joseph Kim J, Weiner DB. Novel prostate cancer immunotherapy with a DNA-encoded anti-prostate-specific membrane antigen monoclonal antibody. Cancer Immunol Immunother. 2017; doi:10.1007/s00262-017-2042-7
Hepatitis B has been eliminated from Alaska
Hepatitis B virus (HBV) infection and associated liver cancer have been eradicated from Alaska thanks to a universal vaccination program of infants and children that started in 1984. In the 1970s the prevalence of HBV and hepatocellular carcinoma (HCC) among Alaska Natives was the highest in the US. There have been no acute HBV and HCC cases in people aged ≤20 since 1992 and 1998, respectively.
Authors of the study1 concluded: “Universal newborn vaccination coupled with mass screening and immunisation of susceptible Alaska Native people has eliminated early-onset HCC and acute symptomatic HBV infection as a public health threat among Alaska Native children. This population-based approach can serve as a model for other populations.”
1. World Hepatitis Alliance. “Study shows universal vaccination has wiped out hepatitis B and associated liver cancer in Alaska's young people.” http://www.worldhepatitisalliance.org/news/aug-2017/study-shows-universal-vaccination-has-wiped-out-hepatitis-b-and-associated-liver; accessed September 13 2017
Progress with PD-L1-targeting immunotherapy
The anti-PD-L1 MAb durvalumab (Imfinzi, AZ) was granted a breakthrough designation by the FDA for locally-advanced, unresectable non-small cell lung cancer. The decision is based on interim results of a Phase 3 trial, in which durvalumab improved progression-free survival compared to placebo.
Another study combined an anti-PD-L1 MAb with photothermal nanotherapy to treat bladder tumors in a mouse model.1 In this approach, gold nanostars, which preferentially accumulate in the cancer tissue due to its leaky vasculature, convert laser irradiation to heat, thereby killing the cells. The combination therapy completely eliminated the tumor in 2 out of 5 mice with no sign of recurrence after 2 months.
1. Liu Y, Maccarini P, Palmer GM, Etienne W, Zhao Y, Lee CT, Ma X, Inman BA, Vo-Dinh T. Synergistic Immuno Photothermal Nanotherapy (SYMPHONY) for the Treatment of Unresectable and Metastatic Cancers. Sci Rep 2017; 7(1):8606
CDC recommendation might be behind a decrease in influenza vaccination coverage
The drop in influenza vaccine uptake in US children during the 2016–7 season might have been caused by the CDC recommendation against the nasal spray route of administration. Although it is often parents’ first choice due to its painlessness compared to injection, the nasal spray formulation was found to be less effective in preventing influenza.
According to the study, which analyzed nearly 10,000 Penn State patients aged 2–17, vaccination rates were 1.6% lower in 2016–7 compared to 2015–6.1 While previous studies found vaccine uptake in a given year to be the best predictor for taking the vaccine the next season, this research suggests that up to 50% of people change their minds from one year to the next.
“It seems that people may not be either vehemently pro-flu vaccine or anti-flu vaccine; rather if it's convenient, they'll get the vaccine, and if it's not convenient, they won't go out of their way to get it,” lead author Benjamin Fogel of Penn State College of Medicine said.
1. Fogel B, Hicks S. Influenza vaccination rates in children decline when the live attenuated influenza vaccine is not recommended. Vaccine 2017; 35(39):5278-5282
Vaccines against substance abuse in preclinical development
Scientists from the Scripps Research Institute have made progress in the development of vaccines against heroin and fentanyl. The former, which prevents heroin to bind to the opioid receptor, showed efficacy in monkeys.1 It is specific to a heroin metabolite that is not associated with other opioids, e.g., those used as pain-killers.
The other vaccine is against the synthetic opioid fentanyl, which is sometimes added to heroin and contributes to overdose deaths. “There is an urgent need to discover effective medications to treat substance use disorders. Increasingly, drug users are turning to opioids and powerful synthetic versions of these drugs that can sometimes be as much as 100 times more potent than heroin,” study leader Kim Janda told the media.
1. Bremer PT, Schlosburg JE, Banks ML, Steele FF, Zhou B, Poklis JL, Janda KD. Development of a Clinically Viable Heroin Vaccine. J Am Chem Soc 2017; 139(25):8601-8611
Whole-cell cholera vaccines provide little protection to children
Killed whole-cell oral cholera vaccines reduce the risk of contracting the disease by 60% in adults but only by 30% in children <5 years old. According to a meta-analysis of 7 trials, a one-dose regimen provides similar protection to the widely used two-dose regimen.1 This finding might be important during outbreaks, such as the one currently faced by Yemen.
“In cholera-prone areas, public health decision makers don't always have the luxury of caring about the outbreak risk in two years,” senior author Andrew Azman of Johns Hopkins Bloomberg School of Public Health said. “They care about the risk of transmission tomorrow or in two weeks or next month. Being able to vaccinate twice the number of people with a limited quantity of vaccine can be very important.”
1. Bi Q, Ferreras E, Pezzoli L, Legros D, Ivers LC, Date K, Qadri F, Digilio L, Sack DA, Ali M, Lessler J, Luquero FJ, Azman AS; Oral Cholera Vaccine Working Group of The Global Task Force on Cholera Control. Protection against cholera from killed whole-cell oral cholera vaccines: a systematic review and meta-analysis. Lancet Infect Dis 2017; doi:10.1016/S1473-3099(17)30359-6