ideasIdea
A therapeutic vaccine to clear cervical precancer without surgery
Precancer is treated by cutting away part of the cervix, which raises pregnancy risks. A vaccine that makes the immune system clear the infected cells would avoid surgery.
DNA vaccines such as VGX-3100 showed roughly 20-30 percentage points higher regression of CIN2/3 than placebo. Propose next-generation therapeutic vaccines (mRNA or E6/E7-targeted) tested with CIN2/3 regression plus HPV clearance as endpoints, aimed first at women planning pregnancy.
Hypothesis
A therapeutic HPV vaccine achieves at least 50% histological regression with viral clearance at six months in CIN2/3, allowing surgery to be avoided in half of treated women.
Rationale
HPV oncoproteins are foreign antigens present in every lesion cell, and partial efficacy is already proven.
What would test it
Run a phase 2b RCT of 400 women with a regression endpoint.
Maturity
early clinical
Who has to act
industry
Cost to try
Medium ($1M to $50M)
Years to first evidence
5
Bottlenecks it attacks
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.
- Overdiagnosis and false alarms · Finding more cancer is not the same as saving lives. Screening also finds cancers that would never have hurt anyone, and treats them.