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Vacunación VPH de dosis única para la prevención del cáncer de cuello uterino en mujeres adultas jóvenes en Costa Rica, el ensayo PRISMA ESCUDDO (PRISMA)

21 de octubre de 2026 actualizado por: National Cancer Institute (NCI)

Vacunación VPH de dosis única entre mujeres adultas jóvenes en Costa Rica: el ensayo 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.

Descripción general del estudio

Descripción detallada

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.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

5000

Fase

  • Fase 4

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

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

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 30 años (Adulto)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Femenino

Descripción

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.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Prevención
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Doble

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Arm I (Gardasil 9)

Participants receive one dose of Gardasil 9 IM.

Ancillary studies

Given IM

Otros nombres:
  • Gardasil 9
  • Vacuna VLP contra el VPH nonavalente
  • Vacuna nonavalente contra el VPH recombinante
  • Vacuna recombinante del Virus del Papiloma Humano 9-valente
Experimental: Arm II (Cervarix)

Participants receive one dose of Cervarix IM.

Ancillary studies

Given IM

Otros nombres:
  • Cervarix
  • GSK-580299
  • VPH 16/18 L1 VLP/AS04 VCA
  • Vacuna HPV-16/18 VLP/AS04
  • Virus del papiloma humano 16/18 L1 Partícula similar al virus/Vacuna AS04
  • Vacuna recombinante contra el virus del papiloma humano bivalente tipos 16 y 18
  • Vacuna Virus Papiloma Humano L1 16,18
  • Vacuna contra el virus del papiloma humano, tipo L1 16, 18
  • Vacuna bivalente contra el VPH recombinante
Comparador activo: Arm III (Adacel)

Participants receive one dose of Adacel IM.

Ancillary studies

Given IM

Otros nombres:
  • Adacel
  • Daptacel
  • Toxoide diftérico/toxoide tetánico/vacuna contra la tos ferina acelular
  • DTaP
  • Toxoides diftérico y tetánico y vacuna acelular contra la tos ferina adsorbida
  • Toxoide diftérico Toxoide tetánico Vacuna acelular contra la tos ferina adsorbida
  • Infanrix
  • Tripedia

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Incident persistent human papillomavirus (HPV) 16 or 18 infection
Periodo de tiempo: 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

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Benefit of one dose of HPV vaccination compared to no vaccination
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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)
Periodo de tiempo: 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

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Aimee R Kreimer, National Cancer Institute (NCI)

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

1 de marzo de 2022

Finalización primaria (Estimado)

15 de enero de 2027

Finalización del estudio (Estimado)

14 de enero de 2028

Fechas de registro del estudio

Enviado por primera vez

8 de febrero de 2022

Primero enviado que cumplió con los criterios de control de calidad

8 de febrero de 2022

Publicado por primera vez (Actual)

14 de febrero de 2022

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

22 de octubre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

21 de octubre de 2026

Última verificación

1 de octubre de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • NCI-2022-00343
  • NCI-2022-00343 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • DCEG ERP 22G001-01
  • CEC-FUNIN-007-2021
  • 154376 (Otro identificador: National Cancer Institute)

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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