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Jednodávkové očkování proti HPV pro prevenci rakoviny děložního čípku u mladých dospělých žen v Kostarice, studie PRISMA ESCUDDO (PRISMA)

21. října 2026 aktualizováno: National Cancer Institute (NCI)

Jednodávkové očkování proti HPV u mladých dospělých žen v Kostarice: studie PRISMA-ESCUDDO (PRevencIón Del Cáncer Cervical Con Una Sola Dosis de Vacuna Contra VPH en Mujeres Adultas Jóvenes)

This phase IV trial tests whether a single dose of the human papillomavirus (HPV) vaccine works in preventing cervical cancer in young women in Costa Rica. Human papilloma viruses, called HPV, are a group of viruses that very frequently cause infection in both men and women, mainly in the genital organs. There are many types of HPV, and some can cause cancer. The World Health Organization recommends a two-dose schedule for adolescents 9-14 and three doses for individuals 15 years old or older. This study examines whether a single dose of HPV vaccine can reduce the frequency with which women between ages 18-30 become infected with HPV.

Přehled studie

Detailní popis

PRIMARY OBJECTIVES:

I. To evaluate one dose of nonavalent human papillomavirus (HPV) vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years who are cervical HPV16/18 deoxyribonucleic acid (DNA) negative prior to and at the time of vaccination.

II. To evaluate one dose of bivalent HPV vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years who are cervical HPV16/18 DNA negative prior to and at the time of vaccination.

SECONDARY OBJECTIVES:

I. To quantitate the benefit of one dose of HPV vaccination compared to no vaccination in the protection against incident HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years regardless of cervical HPV DNA status at the time of vaccination (i.e.: vaccine effectiveness in an intention to treat [ITT] analytical cohort).

II. To evaluate one dose of HPV vaccination compared to no vaccination in the protection against cervical infections that persist 6-months or more in women aged 18 to 30 years for the following HPV groupings and individual HPV types (analyzed in an ATP cohort and an ITT cohort):

IIa. Seven carcinogenic types in the nonavalent HPV vaccine: HPV 16/18/31/33/45/52/58 (analyzed both as an aggregate group and individually); IIb. Non-carcinogenic, genital warts-associated types: HPV 6/11 (analyzed both as an aggregate group and individually).

III. To evaluate one dose of HPV vaccination compared to no vaccination in the protection against HPV16/18 anal and oral infections that persist 6-months or more in women aged 18 to 30 years (analyzed in an ATP cohort and an ITT cohort).

IV. To evaluate the immunogenicity (absolute levels, proportion of seropositivity, and stability of serum antibodies) of single dose HPV vaccination in women aged 18 to 30 years. When looking at these antibodies, the primary focus will be on HPV16/18; antibodies against additional HPV types included in the nonavalent HPV vaccine will also be investigated.

ANCILLARY OBJECTIVES:

I. To evaluate one dose of HPV vaccination compared to no vaccination in the protection against HPV cervical, anal or oral infection detected at a single timepoint in women aged 18 to 30 years, including but not limited to the following endpoints:

Ia. HPV16/18; Ib. HPV 16/18/31/33/45/52/58; and Ic. HPV6/11. II. To estimate the health impact of older-age single-dose HPV vaccination by modeling the number of cervical cancer cases prevented as well as the cost-effectiveness of cervical cancer prevention strategies incorporating vaccination and screening in Costa Rica.

OUTLINE: Participants are randomized to 1 of 3 arms.

ARM I: Participants receive one dose of recombinant human papillomavirus nonavalent vaccine (Gardasil 9) intramuscularly (IM).

ARM II: Participants receive one dose of recombinant human papillomavirus bivalent vaccine (Cervarix) IM.

ARM III: Participants receive one dose of diphtheria toxoid/tetanus toxoid/acellular pertussis vaccine adsorbed vaccine (Adacel) IM.

After completion of randomization and vaccination, participants are followed for 36 months. At 6 months they receive a phone contact and, thereafter, they participate in cervicovaginal self-sampling every 6 months, annual serology, and oral/anal sampling at selected visits.

Typ studie

Intervenční

Zápis (Odhadovaný)

5000

Fáze

  • Fáze 4

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Guanacaste Province
      • Liberia, Guanacaste Province, Kostarika, 50101
        • Agencia Costarricense de Investigaciones Biomédicas (ACIB)

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let až 30 let (Dospělý)

Přijímá zdravé dobrovolníky

Ano

Pohlaví způsobilá ke studiu

Ženský

Popis

Inclusion Criteria:

  • INCLUSION CRITERIA AT ENROLLMENT: Female.

  • INCLUSION CRITERIA AT ENROLLMENT: Aged between 18 and 30 years inclusive.

  • INCLUSION CRITERIA AT ENROLLMENT: Living in the study area.

  • INCLUSION CRITERIA AT ENROLLMENT: Able to communicate with study personnel.

  • INCLUSION CRITERIA AT ENROLLMENT: Willing to participate in the study and sign the informed consent.

  • INCLUSION CRITERIA AT ENROLLMENT: In good health as determined by a medical history (physical exam will be conducted if necessary per the doctor's criterion).

  • DEFERRAL CRITERIA AT ENROLLMENT VISIT: The enrollment visit will be deferred (i.e., rescheduled for another date) for participants if: the self-collected cervical sample is not able to be collected.

  • DEFERRAL CRITERIA AT THE VACCINATION VISIT: The vaccination visit will be deferred (i.e., rescheduled for another date) for participants if:

    • They have an acute disease that precludes vaccination (though vaccines can be administered to potential participants with a minor illness such as diarrhea and mild upper respiratory infection)
    • They are receiving immunosuppressive treatment, e.g. corticosteroids
    • They have received any registered vaccine in the last 15 days.

Exclusion Criteria:

  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have been vaccinated against human papillomavirus (HPV).
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are allergic to yeast or another vaccine components.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have a diagnosis of an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and / or adequate control that, according to the principal investigator or designee, for which vaccination is contraindicated.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They have plans to move outside the country in the next six months.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They refuse or are unable to self-collect the cervical sample.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They are pregnant.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: They do not have an identification document.
  • EXCLUSION CRITERIA AT ENROLLMENT VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they have been vaccinated against HPV.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: Between the enrollment and vaccine visit, they are being evaluated for or have received a diagnosis of: an autoimmune, degenerative, or neurological disease without treatment or adequate control; a progressive or severe neurological disease; a genetic immunodeficiency; or any other serious chronic disease without treatment and/or adequate control, for which vaccination is contraindicated according to the principal investigator or designee.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They have plans to move outside the country in the next six months.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse the urine pregnancy test.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They have a positive urine pregnancy test result.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They are pregnant.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: They refuse or are unable to perform the self-collected cervical sample.
  • EXCLUSION CRITERIA AT VACCINATION VISIT: The clinician determining eligibility in agreement with the principal investigator considers that there is a reason that precludes participation.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Prevence
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Dvojnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Arm I (Gardasil 9)

Participants receive one dose of Gardasil 9 IM.

Ancillary studies

Given IM

Ostatní jména:
  • Gardasil 9
  • Nenavalentní HPV VLP vakcína
  • Rekombinantní HPV nenavalentní vakcína
  • Rekombinantní 9valentní vakcína proti lidskému papilomaviru
Experimentální: Arm II (Cervarix)

Participants receive one dose of Cervarix IM.

Ancillary studies

Given IM

Ostatní jména:
  • Cervarix
  • GSK-580299
  • HPV 16/18 L1 VLP/AS04 VAC
  • Vakcína HPV-16/18 VLP/AS04
  • Lidský papillomavirus 16/18 L1 Virus-like Particle/AS04 vakcína
  • Bivalentní vakcína proti lidskému papilomaviru typu 16 a 18, rekombinantní
  • Vakcína proti lidskému papilomaviru L1 16,18
  • Vakcína proti lidskému papilomaviru, L1 typ 16, 18
  • Rekombinantní HPV bivalentní vakcína
Aktivní komparátor: Arm III (Adacel)

Participants receive one dose of Adacel IM.

Ancillary studies

Given IM

Ostatní jména:
  • Adacel
  • Daptacel
  • Toxoid záškrtu/tetanový toxoid/acelulární vakcína proti černému kašli
  • DTaP
  • Toxoidy záškrtu a tetanu a adsorbovaná acelulární vakcína proti černému kašli
  • Toxoid záškrtu Toxoid tetanu Adsorbovaná acelulární vakcína proti černému kašli
  • Infanrix
  • Tripedie

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Incident persistent human papillomavirus (HPV) 16 or 18 infection
Časové okno: 6-month persistence observed during follow-up

Will estimate the rate of incident persistent infections (i.e. the primary endpoint defined above) in each of the three arms of an according to protocol (ATP) cohort and then estimate the two Vaccine Efficacies (VE), comparing each HPV vaccine arm against the control arm, with hypothesis testing for H0: VE =< 0.3. Will require a one-sided p-value of < 0.0125 for statistical significance.

6-month persistence observed during follow-up

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Benefit of one dose of HPV vaccination compared to no vaccination
Časové okno: 6-month persistence observed during follow-up

Will evaluate one dose of HPV vaccination compared to no vaccination in the protection against HPV16/18 cervical HPV infections that persist 6-months or more in women aged 18 to 30 years, regardless of cervical HPV deoxyribonucleic acid status at the time of vaccination (i.e.: vaccine effectiveness in an intention to treat [ITT] analytical cohort).

6-month persistence observed during follow-up
Seven carcinogenic types and, separately, the non-carcinogenic types in the nonavalent HPV vaccine
Časové okno: 6-month persistence observed during follow-up

Will evaluate HPV 16/18/31/33/45/52/58 (analyzed both as an aggregate group and individually) and non-carcinogenic, genital warts-associated types: HPV 6/11 (analyzed both as an aggregate group and individually). Will evaluate one dose of HPV vaccination compared to no vaccination in the protection against cervical infections that persist 6-months or more in women aged 18 to 30 years for the following HPV groupings and individual HPV types (analyzed in an ATP cohort and an ITT cohort).

6-month persistence observed during follow-up
Protection against HPV16/18 anal and oral infections
Časové okno: 6-month persistence observed during follow-up

Will evaluate one dose of HPV vaccination compared to no vaccination in the protection against HPV16/18 anal and oral infections that persist 6-months or more in women aged 18 to 30 years (analyzed in an ATP cohort and an ITT cohort).

6-month persistence observed during follow-up
Immunogenicity (absolute levels, proportion of seropositivity, and stability of serum antibodies)
Časové okno: Up to 36 months

Will report the Geometric Mean Concentration, percentage of seropositivity, and cumulative distribution function of the antibodies for each HPV type at the vaccination visit and the 12-, 24-, and 36-month follow-up visits.

Up to 36 months

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Vrchní vyšetřovatel: Aimee R Kreimer, National Cancer Institute (NCI)

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

1. března 2022

Primární dokončení (Odhadovaný)

15. ledna 2027

Dokončení studie (Odhadovaný)

14. ledna 2028

Termíny zápisu do studia

První předloženo

8. února 2022

První předloženo, které splnilo kritéria kontroly kvality

8. února 2022

První zveřejněno (Aktuální)

14. února 2022

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

22. října 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

21. října 2026

Naposledy ověřeno

1. října 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • NCI-2022-00343
  • NCI-2022-00343 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
  • DCEG ERP 22G001-01
  • CEC-FUNIN-007-2021
  • 154376 (Jiný identifikátor: National Cancer Institute)

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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