Imiquimod with or without 9-Valent HPV Vaccine in Treating Patients with High-Grade Pre-neoplastic Cervical Lesions

Inclusion Criteria

• Subjects must have untreated cervical biopsy-proven, CIN 2/3 ectocervical lesion(s).
• Subjects must have satisfactory colposcopy with visualization of the entire transformation zone or a negative endocervical curettage if colposcopy is unsatisfactory.
• Subjects must be high-risk HPV+ as determined by commercially available deoxyribonucleic acid (DNA) hybridization test which tests for 13 high-risk HPV types.
• All subjects must have a histologic diagnosis of CIN 2,3 cervical lesion(s) confirmed by a study pathologist.
• Subjects must have signed an approved informed consent.
• Subjects of childbearing potential must have a negative urine pregnancy test within 7 days prior to the study entry and be practicing an effective form of contraception.
• Subjects must be at least 18 years of age based on previous and current cervical cancer screening guidelines.
• Subjects must be fluent in speaking English or Spanish.

Exclusion Criteria

• Subjects with unsatisfactory colposcopy* (unable to visualize entire transformation zone) or evidence of endocervical disease defined as CIN 2/3 diagnosed on endocervical curettage. *Subjects with unsatisfactory colposcopy but negative endocervical curettage are eligible
• Subjects with a history of invasive cervical cancer.
• Subjects with a history of other invasive malignancies, with the exception of non-melanoma skin cancers are excluded if there is any evidence of other malignancy being present within the last five years. Subjects are also excluded if their previous cancer treatment contraindicates this protocol therapy.
• Subjects with any unstable medical issue (including cardiac issues as above, active treatment for pulmonary embolism, cerebrovascular accident [CVA], renal or hepatic insufficiency, active infection/sepsis requiring IV antibiotics).
• Subjects who have an uncontrolled seizure disorder, or active neurological disease.
• Subjects known to be seropositive for human immunodeficiency virus (HIV) and active hepatitis, even if liver function studies are in the normal range. Subjects otherwise immunocompromised will also be excluded (chronic steroid use, taking immunosuppressive medications).
• Pregnant or breastfeeding subjects.
• Subjects who have had a total hysterectomy (removal of uterus and cervix) or trachelectomy (removal of cervix).
• Subjects with a known hypersensitivity to imiquimod. Subjects with a known hypersensitivity to any prophylactic HPV vaccine or severe allergic reactions to yeast (vaccine component).
• Subjects who have received their first dose of HPV vaccine < 4 weeks ago or their second dose < 12 weeks ago.
• Known hypersensitivity or prior intravaginal treatment with imiquimod.