OncoLink News Flash: Gynecologic Cancer Update

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Carolyn Vachani, RN, MSN, AOCN
Abramson Cancer Center of the University of Pennsylvania
Last Modified: February 4, 2007

Last month's OncoLink poll asked "Do you feel that it is important to have your school-aged daughter vaccinated against HPV?" The results of our unscientific poll found 85% of the respondents said yes. However, wanting the vaccine and getting it are two different things. There is the issue of availability, as many doctor's offices are not carrying the vaccine yet. The manufacturer did start shipping the vaccine in 2006, and the hope is that it will be more widely available in 2007, so keep asking!

The issue of cost must also be considered. The series of 3 injections, given over the course of a year, will cost about $120 per shot, not including administration or office visit fees. The Advisory Committee on Immunization Practices (ACIP) has recommended that insurance companies cover the costs, but this can take some time to occur. Contact your insurance company to see if they are or will be covering the vaccine. The ACIP also voted to recommend that the HPV vaccine be included in the federal Vaccine for Children (VFC) entitlement program, which covers vaccine costs for children and teens without insurance and for some children and teens who are underinsured.

The currently available vaccine, Gardasil (Merck), covers HPV strains 16 and 18 (cancer-causing strains), as well as 11 and 6 (responsible for genital warts). Glaxo Smith Kline ( GSK ) has produced Ceravix, an HPV vaccine for which they plan to file for FDA approval in April 2007. This vaccine covers strains 16, 18, 45 and 31 (cancer-causing strains). GSK is currently launching a clinical trial to compare the two vaccines. The primary objective is to compare the immune responses to HPV 16 and 18 in women ages 18-26, secondarily they will examine immune responses in women ages 27-35 and 36-45. GSK 's vaccine uses a different formulation (called AS04), which was found in a study to result in stronger and longer-lasting immunity. The study results will not be available for another 1-2 years.

Some other news in the world of gynecologic cancers includes two new legislative pieces. The Gynecologic Cancer Education and Awareness Act, also known as Johanna's Law, was signed into law by President Bush in January. The bill will provide $16.5 million for Health and Human Services to use for a national campaign to increase awareness and knowledge of gynecological cancers among both the public and health care providers. This would be achieved through the distribution of written materials and the use of public service announcements encouraging women to talk with their healthcare providers about gynecologic cancers.

In the state of New Jersey, Senate Bill 544 was introduced. This bill would require health insurers to cover cervical cancer screenings (Pap smears) and any confirmatory tests, as well as HPV testing. To read more about the bill or to email your New Jersey legislator in support of the bill, visit the New Jersey Legislature website.