Researchers at the University of Manchester are developing a topical treatment against the human papilloma virus (HPV) which is responsible for pre-cancerous and cancerous disease of the cervix as well as other genital malignancies.
In the UK many thousands of women undergo surgery to remove precancerous lesions of every year. Instead they may be able to apply a simple cream or pessary to the affected area. The discovery may be even more significant in developing countries which lack surgical facilities and where HPV related cervical cancer is one of the most common forms of cancer in women.
Drs Ian and Lynne Hampson at the School of Medicine's Division of Human Development and Reproduction are developing the treatment from a type of drug that is given orally to treat HIV. This protease inhibitor can selectively kill cultured HPV infected cervical cancer cells and, since it is already available as a liquid formulation, it is possible it may work by direct application to the cervix.
The research, funded by the Humane Research Trust, is to be published in the September issue of the journal Anti-Viral Therapy (2006; 11(6): in press) and is also being presented at the International HPV meeting in Prague on 5 September.
Group leader Dr Ian Hampson, who is based at St Mary's Hospital, Manchester, said: "It is very exciting to find such a significant new use for this HIV drug which is already licensed and FDA-approved for oral administration. We are currently exploring the means of delivering this drug directly to the affected tissue. We would then move to a clinical trial that would be supervised by our head of unit Professor Henry C. Kitchener. If this proves successful we could see the treatment available fairly rapidly."
He added: "Anti HPV vaccines are currently in the process of being licensed but, not all lesions will be prevented and not all women will be vaccinated. A non surgical therapy will have significant advantages -- better preservation of obstetric function, the potential for use in resource poor settings such as underdeveloped countries and it may appeal more to women than surgery.
"We are very grateful for the strong support we have had from the Humane Research Trust, the charity who funded the development of this work."
Professor Kitchener said: "The significance of this finding is that a simple medical treatment could be used in place of surgery which many women dislike and fully preserve the cervix. First we need to demonstrate that it can be effective."
Human Papilloma Virus (HPV): Infection with high risk HPV is the cause of the vast majority of cervical carcinomas. The disease is characterised by sequential progression over a period of several years. In the developed world the incidence of cervical cancer has been declining steadily due to the use of cervical screening and surgery where necessary. This is highly effective with an efficacy of 90-95 percent and although re-treatment may be required, the subsequent risk of cancer is around 0.5%. Even though many low grade cervical lesions may regress without the need for surgical intervention, current clinical practice is to treat all high-grade lesions.
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