When it comes to cidofovir, although scientists are not entirely sure exactly how it works, they know that it inhibits the viral DNA polymerase and it definitely targets rapidly dividing cells.
Explore This IssueSeptember 2006
One important thing to remember is the RRP is different in juvenile disease than it is in adult disease and, consequently, when you look at the literature, you tend to see much different response rate in adults than in children, he said. The tendency we see is that adults seem to respond better to cidofovir, perhaps because their presentation of disease is generally far less severe.
The main issue, and the 800-pound gorilla when it comes to cidofovir, is the question of toxicity-the carcinogenesis of cidofovir.
The concern is that you’re injecting this medicine into the cells, it’s being taken up by the cells, and it may disrupt the genomic integrity of the cell and that’s what ultimately may generate a problem with progressive dysplasia, Dr. Pransky said. It’s difficult to know whether what we’re seeing is the natural history of the disease that might be particularly severe, or if the cidofovir is actually acting as an agent bringing about the changes.
Prevention on the Horizon?
The most promising glimpse into the future of RRP, however, does not involve treatment-it’s about prevention and the development of two extremely promising vaccines: the quadrivalent Gardasil, which recently received FDA approval, and the bivalent vaccine Cervarix, which is expected to be submitted for approval later this year.
Early trials have been so successful that things are moving ahead fairly quickly with both of these vaccines, Dr. Pransky said. We hope they will pave the way to make RRP a disease of the past. This is where the future is and where we will need to focus a lot of our efforts.
©2006 The Triological Society