An article in Sunday's New York Times discusses the issues involved in marketing Gardasil for boys, and notes the vaccine could receive FDA approval for boys in 2009. The role of HPV in some head and neck cancers is very briefly noted in the last third of the article.

-- Leslie

I was wondering when they were going to market this for boys. It only makes sense!

girlcat,

They have been going thru the FDA approval process for quite some time. Let's hope it receives their approval quickly.

http://www.oralcancerfoundation.org/presskit/pr/hpv_vaccine.pdf

Brian,
Are you aware of any trials where the Gardasil vaccine is being to men who developed oral cancer and were p16+? My doctor at UCSF said there is no clinical data to suggest a benefit but she would still get the vaccine after I heal from my treatments. She said it is possible that it might do something to boost my immunity against the disease. I would love to hear your thoughts on this matter.

Also, is there any benefit to determining the exact cause of a p16+ test?

Thanks

Johns Hopkins has been conducting a Phase I clinical trial of a vaccine (not Gardasil) for patients with HPV+ tumors, though it sounds from the most recent postings (last year) that the trial has closed. These three threads have a lot of information about it.

-- Leslie

I answered this question on another thread. What you should be interested in (as I am) are any positive results that come from this very small, and VERY early, trial of a vaccine against recurrence of the virus that Leslie mentions. The trial is closed. Now we wait to find out the results. You have to remember that understanding of it all, and the final commercialization of any vaccine that might result from it, is YEARS down the road, and millions of dollars in investments.

I want to know if the cause of my positive p16 test means that I am HPV positive. What is the best way to determine if I am, in fact, HPV positive, and if so, what strain?

I have asked my doctors and they said the subject is of academic interest but of no clinical value.

While I agree that the knowledge would not have changed my treatment decision, I want to know. There might be clinical value to the information in the future. Is it best to have the tissue tested while it is still fresh?

How have others approached this issue? Any help would be appreciated.

On another note, I had my first IMRT treatment today and will have my first concurrent Cisplatin treatment tomorrow.
Thanks

I

It means that a some point in the past you were for sure. Whether you are now is an unknown. There is no reliable means to test men at this point. Where would we collect the sample from? We don't know if it goes dormant, and if so where. You could do a blood test to look for a type specific antibody. But that is still a refection of the past. The odds are, from all previous studies, that you were type 16 positive. And as stated before this would be of unknown value to know, and other than 16 I do not know of any clinical work being done on the few other oncogenic versions in head and neck, because they are not major players.

Frank,

I'm not sure I understand your question or the "no clinical value" statement made by your doctors. I assume your bio tested positive for HPV 16 which means that your cancer was caused by the HPV strain 16 and that has recently proved of clinical value, i.e. the difference between HPV + and HPV - cancer. But if your question is am I still HPV + ? and their response is "no clinical value" then I would still scratch my head. Yes there presently is no HPV test for males other than a bio but if you were still positive I would think that would be of some clinical value to someone and I would hope as I did with me that our rad Tx would kill not only the cancer but the virus as well. Not an expert here but I still have a million unanswered questions about this virus that tried to kill me.

It has no value in determining treatments. So from those doctors perspective it doesn't mean much. The few institutions that have stopped doing neck dissections as a change in treatment protocol, MAY be right that it isn't needed, but in my opinion and in the opinion of lecturers that I listed to, this is a fuction of staging to do it or not, and less influenced by HPV status. Even with a low staging, it is too early to tell if this is a good idea or not, we'll know in 5 years. Ditto the very small survival advantage. The data on that is at 5 years. It remains to be be seen if that advantage still exists at 10 years. The treatments kill the cells, and by extention, anything that they contain like a virus for instance. But that does not mean that it kills a virus that may be located dormant or active in any other part of your body. We are seeing HPV positive paitents develop second HPV positive primaries in areas far removed from their original lesion. Cervical cancer patients developing an oral cancer, or an oral cancer patient developing an anal cancer. These are all possible indicators that the virus has some mechanism (unknown at this time) of moving around the body. The issue of whether or not the virus can be dormant in your body for protracted periods of time is still an unknown at this time, with different people expressing very different opinions based solely on best guess probabilities, those based on the behavior of other viruses. The clinical value as a determiner of treatment or a prognosticator of LONG TERM survival advantage, of a patient's HPV status, at this time is unknown.