Injection of the 9-valent human papillomavirus (HPV) vaccine caused the complete regression of all cutaneous squamous cell carcinoma (SCC) tumours in a 97-year-old woman with multiple SCCs, according to a report in JAMA Dermatology (July 3, 2018). Researchers say that in the future, the HPV vaccine may be used as a cost-effective alternative to treat patients with SCC who refuse surgery, have multiple lesions, or are poor surgical candidates.
The elderly patient’s right leg was covered with SCC tumours. She was not a candidate for surgery or radiotherapy because of the size and number of her tumours. In a previous study, Dr. Anna Nichols, senior study author and dermatologist at Sylvester Comprehensive Cancer Center, University of Miami Health System in Miami, reduced SCC and basal cell carcinoma tumours in two patients using the HPV vaccine (JAMA Dermatol 2017 153(6):571–574). These patient outcomes prompted Dr. Nichols to use the HPV vaccine—approved for the prevention of cervical, vaginal, vulvar, and anal cancer—as an off-label therapy for her 97-year-old patient.
First, two doses of the 9-valent HPV vaccine were administered into the patient’s arm, six weeks apart. A few weeks later, Dr. Nichols directly injected several, but not all, of the patient’s tumours. The direct injections were given four times over a span of 11 months.
“All of her tumours completely resolved 11 months after the first direct tumour injection, and she has had no recurrence,” said Dr. Nichols in a press release. “It has been about 24 months now since we started with the treatment.”
An image of an SCC tumour before treatment shows
central comedolike necrosis and atypical basaloid cells with mitoses.
Photo by University of Miami.
According to the researchers, this is the first case study showing a complete regression of SCC malignant tumours through HPV vaccine injections. The patient is now looking forward to celebrating her 100th birthday this autumn.
“I think we had a really reasonable expectation and good data that this was actually going to, at the very least, do no harm to this patient, and possibly provide some benefit,” said study co-author Dr. Tim Ioannides, founder of Treasure Coast Dermatology and voluntary associate professor at the University of Miami School of Medicine, in Miami. “To have this type of result in such an advanced patient I think was beyond all our expectations.”