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A new vaccine for cervical cancer and some good hope

Cervical cancer is the most common cancer among Indian women, with an estimated 1.32 lakh new cases and 74,000 deaths annually.

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Cervical cancer is the most common cancer among Indian women, with an estimated 1.32 lakh new cases and 74,000 deaths annually, says a report.

The deadly cancer which affects the uterine cervix — the lower part of the uterus — is not a hereditary cancer that develops as a result of a genetic mutation  (unlike breast, prostrate and ovarian cancer). It is caused by a virus, the human papillomavirus (HPV), which is transmitted sexually or because of poor hygiene.

Now, recent data from the All India Institute of Medical Sciences (AIIMS) in New Delhi states that although a wide spectrum of HPV is seen across India, HPV-16 and HPV-18 are the most common types and a vaccine targeting these types could eliminate 75% of cervical cancers in the country.

Neerja Bhatla, assistant professor in the department of obstetrics and gynaecology, AIIMS, says, “HPV-16 and -18 are identified as the most common genotypes of the virus in India, and vaccination, if done before the person becomes sexually active, would offer great protection.”

This would be a shot in the arm for US pharmaceutical giant Merck and British major GlaxoSmithKline (GSK), both of which have been selling cervical cancer vaccines in the country for about a year. Both Merck’s Gardasil and GSK’s Cervarix offer protection against HPV-16 and -18 and are given in three doses over a six-month period.

Last year, worldwide sales of Gardasil were worth about $1.4 billion, while those of Cervarix were about $232 million.

With the US FDA (Food & Drug Administration, the world’s foremost body monitoring drugs and vaccines) recently approving Gardasil for prevention of genital warts in males aged between 9 and 26 years, and Cervarix to prevent cervical cancer in females between the ages of 10 and 25 years, the global sales of the two products are expected to go up.

Gardasil also offers protection against HPV-6 and -11, which cause genital warts in males.

But it would be a while before sales of the two vaccines rise in India’s Rs400 crore vaccine market, say healthcare industry experts.

Ranjit Kapadia, vice-president, institutional research, HDFC Securities, says, “The vaccine market is growing at about 15-20% per annum in the country. But in the first year, about Rs2-3 crore of sales are seen.”

Sanjiv Navangul, director, sales & marketing, MSD India, Merck’s India arm, says a 20% month-on-month jump in vaccination is being noticed for cervical cancer.

But a paediatrician from a corporate hospital in Bangalore says the market potential of the drugs in India is limited, as both vaccines are targeted only for girls of a certain age group and Gardasil is not yet approved for use on boys in India.

Moreover, the cost factor would play a role in limiting sales. Gardasil costs Rs2,800 per dose, while Cervarix is priced at Rs3,299 per dose in the Indian market.
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