research
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eu No. 63 | APRIL 2010
25
The search was long. We first succeeded
in extracting the DNA of HPV from plantar
warts. But to our great disappointment we
found no similar traces in the biopsies of gen-
ital warts. This finding, however, led us to
understand that HPV exists in many different
forms. In 1983, a student of our institute,
Mathias Dürst, succeeded for the first time in
cloning a new specific type, HPV 16, which
turned out to be the direct source of infection
for nearly half of all cervical cancers. Two
years later we isolated HPV 18. Today we
have nearly 115 distinct HPVs. But we had
already identified the two HPV types that
are responsible for 7 out of 10 cervical
cancers (
2
).
In recent years, vaccination against these
cancers, unique in its kind, has become increas-
ingly common. Have you been associated with the
long journey to this medical breakthrough?
Since we already had the genomic key to
the HPVs, the idea of developing vaccines
was constantly in our minds. In the ’80s,
I approached a German pharmaceutical firm.
We negotiated, but its decision-makers con-
cluded that there was not a market. This was
a somewhat frustrating period. We had widely
disseminated the knowledge we had acquired,
including sampling and laboratory protocols.
I was a little naive at that time and I did not
think in terms of industrial exploitation and
technology transfer. Our results and methods
were taken up and patented by others. In
1983, I founded the German Cancer Research
Center, based in Heidelberg, which I headed
for 20 years. Over this period, my cancer
research horizons broadened considerably.
Some European media have expressed doubts
about the appropriateness and effectiveness of
the two preventive vaccines that have become
available in recent years. What are your feelings
on these reserves?
These vaccines represent a very significant
innovation. They open for the first time a way
to preventing cancer-linked genetic disorders
that are passed on by infection These repre-
sent at least one cancer in five. This is a highly
complex field of research because the pos-
sibilities of primary infection are vast and the
actual triggering of the cancer phenomenon
may occur very much later.
But such vaccines are as safe as all vaccines
currently administered to children or adoles-
cents. An Australian study, monitoring over
200 000 young girls, has found only minimal
complications. As to effectiveness, even if this
has been demonstrated in the laboratory, it is
obviously too early to confirm this in terms
of real-life results. Being preventive and non-
therapeutic, these vaccines must be adminis-
tered before the possibility of contamination,
that is to say before the first sexual intercourse.
The latency period is then very long. The car-
cinogenic activity of HPV can take more
than two decades to declare itself. The real
reduction in the incidence of cervical cancer
cannot be observed before then.
The resistance of a section of public opin-
ion to vaccination is irrational. In the case
of HPV, which is linked to sexual transmission,
cultural, social and religious taboos surround-
ing the permitted onset of sexual activity come
into play. However, the immediate benefit
of the vaccine against HPV is in preventing
contamination and the appearance of lesions.
It reduces the need for surgical ablation, often
insufficient – 20 % of all lesions go unnoticed
– and which can at times seriously reduce
a woman’s fertility.
Cause for concern remains, however, the
high cost of the vaccine, which is preventing
the protection of women from developing
countries, where more than 80 % of cervical
cancers are identified, accounting for an esti-
mated 250 000 deaths every year. This presents
a real challenge for health policy economics.
A challenge that emerging countries like China
or India may perhaps be able to meet.
You have spent almost your entire research
career without leaving the German university
system. How do you perceive the concept of
a European research area?
On my return from the United States,
the German system of foundations gave me
great freedom of means to fund research, the
objectives of which were far from obvious
in terms of results. In the U.S., research is
extremely powerful, but it is directed more
towards ‘promising’ areas. I would say that,
until recently, Europe has often been able
to give more room for the emergence of orig-
inal ideas at the level of fundamental
research. I do fear, however, that it may find
itself carried away towards a more American
style approach.
What role do you attribute to the European
research programmes?
The German Cancer Research Center is very
active in European projects. I have been
involved, at a greater or lesser distance, in
many projects in virology, genomics and
molecular biology. But there is, I believe, a trap
that we need to avoid, which is wanting to
interconnect everyone at any cost by multiply-
ing networks. Freedom of choice is essential
to scientists. They know where their competi-
tors are and where their allies, and they need
to be able to decide themselves how to broad-
en the scope of their initiatives. Here in
Heidelberg, for example, we are hosting for
the first time a full team of researchers from
Inserm in France who will be doing joint work
with our own people. This type of strong inter-
action between teams of excellence – even if
not without problems of cultural and material
adaptation – seems very fruitful.
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