Concurrent nonavalent human papillomavirus (HPV) vaccination and immune stimulation with imiquimod to treat recalcitrant HPV-associated high grade vaginal intra-epithelial neoplasia

R Farrell; J Zaunders; I M Poynten; L Anderson; L Evans

doi:10.1016/j.gore.2024.101350

Concurrent nonavalent human papillomavirus (HPV) vaccination and immune stimulation with imiquimod to treat recalcitrant HPV-associated high grade vaginal intra-epithelial neoplasia

Gynecol Oncol Rep. 2024 Feb 23:52:101350. doi: 10.1016/j.gore.2024.101350. eCollection 2024 Apr.

Authors

R Farrell^{1

2}, J Zaunders^{3

4}, I M Poynten⁴, L Anderson^{2

5}, L Evans^{6

7}

Affiliations

¹ Chris O'Brien Lifehouse Hospital, Camperdown, Sydney, New South Wales 2050, Australia.
² Sydney Medical School, University of Sydney, New South Wales 2006, Australia.
³ NSW State Reference Labaoratory for HIV, Centre for Applied Medical Research, St Vincents Hospital, New South Wales, Australia.
⁴ HIV Epidemiology and Prevention Program, The Kirby Institute, University of NSW Kensington, Sydney, New South Wales 2052, Australia.
⁵ NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, Sydney, New South Wales 2050, Australia.
⁶ University of NSW Kensington, Sydney, New South Wales 2052, Australia.
⁷ Department of Clinical Immunology, Allergy and HIV, Liverpool Hospital, South Western Sydney Local Health District, Liverpool Sydney, New South Wales 2170, Australia.

Abstract

This is the first report describing detailed T cell responses to viral-like proteins contained in an HPV specific vaccine given in combination with Imiquimod for treatment of persistent VAIN2/3. We postulate that stimulation of the innate immune system with Imiquimod and the specific CD4 and CD8T cell responses following HPV vaccination with Gardasil9^@ combined to induce clinical remission in a woman with treatment-refractory disease.

Keywords: HPV vaccine; Human papillomavirus (HPV); Imiquimod; Vaginal intraepitheial neoplasia (VAIN).

Publication types

Case Reports