Published online Feb 10, 2016. doi: 10.5317/wjog.v5.i1.1
Peer-review started: July 1, 2015
First decision: September 30, 2015
Revised: October 10, 2015
Accepted: November 10, 2015
Article in press: November 11, 2015
Published online: February 10, 2016
Processing time: 216 Days and 16.2 Hours
Immunotherapy for cervical intraepithelial neoplasia (CIN) has not yet reached clinical applicability, but seems sensible and shows promising preliminary results. One of the most promising forms of immunotherapy for CIN may currently be imiquimod, because of its established role in other human papillomavirus (HPV)-induced genital conditions, its promising treatment efficacy in high-grade CIN, and its off-label availability. Although imiquimod cannot yet replace the current gold standard treatment for CIN [i.e., large loop excision of the transformation zone (LLETZ)] in all patients, it may be considered in subgroups of patients; for example, young women who may wish to become pregnant in the future, or patients with recurrent CIN lesions in whom a second LLETZ is to be avoided. Immunotherapy of CIN could be extended to post-treatment vaccination, in order to prevent new HPV infections and disease recurrence.
Core tip: Immunotherapy for cervical intraepithelial neoplasia (CIN) is discussed in light of the natural history of CIN. The pros and cons of the current standard therapy (large loop excision of the transformation zone) and immunotherapy, potential side effects, and available evidence supporting the use of immunotherapy in CIN are addressed.