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1.
Clin Cancer Res ; 23(18): 5460-5468, 2017 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-28600473

RESUMO

Purpose: Response rates to treatment of vulval intraepithelial neoplasia (VIN) with imiquimod and cidofovir are approximately 57% and 61%, respectively. Treatment is associated with significant side effects and, if ineffective, risk of malignant progression. Treatment response is not predicted by clinical factors. Identification of a biomarker that could predict response is an attractive prospect. This work investigated HPV DNA methylation as a potential predictive biomarker in this setting.Experimental Design: DNA from 167 cases of VIN 3 from the RT3 VIN clinical trial was assessed. HPV-positive cases were identified using Greiner PapilloCheck and HPV 16 type-specific PCR. HPV DNA methylation status was assessed in three viral regions: E2, L1/L2, and the promoter, using pyrosequencing.Results: Methylation of the HPV E2 region was associated with response to treatment. For cidofovir (n = 30), median E2 methylation was significantly higher in patients who responded (P ≤ 0.0001); E2 methylation >4% predicted response with 88.2% sensitivity and 84.6% specificity. For imiquimod (n = 33), median E2 methylation was lower in patients who responded to treatment (P = 0.03; not significant after Bonferroni correction); E2 methylation <4% predicted response with 70.6% sensitivity and 62.5% specificity.Conclusions: These data indicate that cidofovir and imiquimod may be effective in two biologically defined groups. HPV E2 DNA methylation demonstrated potential as a predictive biomarker for the treatment of VIN with cidofovir and may warrant investigation in a biomarker-guided clinical trial. Clin Cancer Res; 23(18); 5460-8. ©2017 AACR.


Assuntos
Aminoquinolinas/uso terapêutico , Carcinoma in Situ/tratamento farmacológico , Citosina/análogos & derivados , Metilação de DNA , DNA Viral , Organofosfonatos/uso terapêutico , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Neoplasias Vulvares/tratamento farmacológico , Aminoquinolinas/administração & dosagem , Aminoquinolinas/efeitos adversos , Biomarcadores , Carcinoma in Situ/etiologia , Carcinoma in Situ/patologia , Cidofovir , Citosina/administração & dosagem , Citosina/efeitos adversos , Citosina/uso terapêutico , Quimioterapia Combinada , Feminino , Genes Virais , Humanos , Imiquimode , Estadiamento de Neoplasias , Organofosfonatos/administração & dosagem , Organofosfonatos/efeitos adversos , Papillomaviridae/classificação , Infecções por Papillomavirus/tratamento farmacológico , Infecções por Papillomavirus/virologia , Regiões Promotoras Genéticas , Curva ROC , Resultado do Tratamento , Neoplasias Vulvares/etiologia , Neoplasias Vulvares/patologia
2.
Int J Cancer ; 128(7): 1676-82, 2011 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-20503274

RESUMO

Mounting evidence supports incorporation of HPV testing into cervical screening; however, the optimal test format and target population have yet to be confirmed. Assessment of the potential benefits of type-specific testing requires estimation of the risk associated with infection with individual HPV types. However, the risk posed by individual HPV types may be population specific and influenced by cervical screening practice. The existing data on HPV type-specific risk is derived largely from unscreened populations. Our study addressed the lack of data on HPV type-specific risk in cytologically screened populations using a case-control study of 262 invasive cervical cancers diagnosed in Wales between 2000 and 2006, and 8,428 controls who attended for cytological screening in 2004. The analysis showed that the odds ratios (ORs) for infection with HPV 16 and 18 are considerable; 2770 (95% CI 1050-7320) and 950 (95% CI 330-2740), respectively, and that the OR for other oncogenic types are in general considerably less (ranging, where quantified, from 20.2 to 386 in the same population). The effect of age on OR associated with particular HPV types was also assessed; this indicated that infection with a high-risk HPV in women older than 40 years was associated with an approximately 30-fold increased risk of invasive cervical cancer relative to women younger than 40 years. These results indicate that there is significant prognostic information associated with knowledge of HPV type.


Assuntos
Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Razão de Chances , Infecções por Papillomavirus/diagnóstico , Risco , Reino Unido , Neoplasias do Colo do Útero/diagnóstico
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