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コスタリカの若年成人女性における子宮頸がん予防のための HPV 単回ワクチン接種、PRISMA ESCUDDO 試験 (PRISMA)

2026年10月21日 更新者:National Cancer Institute (NCI)

コスタリカの若年成人女性における単回投与 HPV ワクチン接種: PRISMA-ESCUDDO 試験 (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.

調査の概要

詳細な説明

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.

研究の種類

介入

入学 (推定)

5000

段階

  • フェーズ 4

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

    • Guanacaste Province
      • Liberia、Guanacaste Province、コスタリカ、50101
        • Agencia Costarricense de Investigaciones Biomédicas (ACIB)

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~30年 (大人)

健康ボランティアの受け入れ

はい

受講資格のある性別

女性

説明

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.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:防止
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
実験的:Arm I (Gardasil 9)

Participants receive one dose of Gardasil 9 IM.

Ancillary studies

Given IM

他の名前:
  • ガーダシル9
  • 9価HPV VLPワクチン
  • 組換え HPV 九価ワクチン
  • 組換えヒトパピローマウイルス9価ワクチン
実験的:Arm II (Cervarix)

Participants receive one dose of Cervarix IM.

Ancillary studies

Given IM

他の名前:
  • サーバリックス
  • GSK-580299
  • HPV 16/18 L1 VLP/AS04 VAC
  • HPV-16/18 VLP/AS04ワクチン
  • ヒトパピローマウイルス 16/18 L1 ウイルス様粒子/AS04 ワクチン
  • ヒトパピローマウイルス二価16型および18型ワクチン、組換え
  • ヒトパピローマウイルスワクチン L1 16,18
  • ヒトパピローマウイルスワクチン、L1タイプ16、18
  • 組換え HPV 二価ワクチン
アクティブコンパレータ:Arm III (Adacel)

Participants receive one dose of Adacel IM.

Ancillary studies

Given IM

他の名前:
  • アダセル
  • ダプタセル
  • ジフテリアトキソイド/破傷風トキソイド/無細胞百日咳ワクチン
  • DTaP
  • ジフテリアおよび破傷風トキソイドと無細胞百日咳ワクチンの吸着
  • ジフテリアトキソイド 破傷風トキソイド 無細胞百日咳ワクチン 吸着
  • インファンリクス
  • トライペディア

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Incident persistent human papillomavirus (HPV) 16 or 18 infection
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Benefit of one dose of HPV vaccination compared to no vaccination
時間枠: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
時間枠: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
時間枠: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)
時間枠: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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Aimee R Kreimer、National Cancer Institute (NCI)

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2022年3月1日

一次修了 (推定)

2027年1月15日

研究の完了 (推定)

2028年1月14日

試験登録日

最初に提出

2022年2月8日

QC基準を満たした最初の提出物

2022年2月8日

最初の投稿 (実際)

2022年2月14日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月22日

QC基準を満たした最後の更新が送信されました

2026年10月21日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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