Hi all --

Another update on the HPV vaccine trial -- Barry and I went up to Hopkins yesterday for his last injection (of four) -- he also met with the ENT for a check-up and also, they took a lot of what they call "study blood" for immune function analysis. This will all be analysed when all four cohorts (4 vaccine doses) have been completed so some months to come to find out results.

As usual, the injection caused no reactions nor any side-effects. So far so good on that.

The exam by the ENT showed everything still "all clear." It was a very interesting meeting, however - as it was the first time the surgeon has expressed an opinion that HPV positive head/neck cancer probably needs a different therapeutic approach than HPV negative cancer. What he said was, "there is probably no reason to call these patients back in for a neck dissection if they have successfully gone through chemoradiation, as these HPV+ cancers respond so well to that treatment and are unlikely to recur. However, I still want to do a ND on HPV- patients because of their risk of recurrence." Six months ago he would not have said that, in fact he was still a bit "miffed" that Barry had declined ND. Now he agrees it was the right decision.

I also spoke to our chemotherapy nurse -- she said that Hopkins is now testing very HNC patient for HPV and has been doing so for 2 years, She said they are finding the rate of HPV-positive oropharyngeal cancer to be about 70-80% (!!). They have been doing some comparative studies now that patient groups can be separated by HPV status, and these confirm what the ENT said re response to treatment and recurrence.

She also said the "multi-million-dollar" question is: if an HPV+ cancer is successfully treated, is the virus still there (perhaps in a latent state) and can there be -- long-term --problems from this? HPV oral cancers have not been studied long enough to know what happens 10-12 years out. One reason everyone hopes this vaccine works, as one goal is to rid the cancer patients of their viral burden. (And we note, the follow-up for the trial is for 15 years...)

Gail