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Biopharmaceuticals Oncology

 News Release - November 13, 2008

GARDASIL®, Merck's Cervical Cancer Vaccine, Demonstrated Efficacy in Preventing HPV-Related Disease in Males in Phase III Study

Pivotal Study Evaluating Efficacy of GARDASIL in Males in Preventing HPV 6, 11, 16 and 18-Related External Genital Lesions

WHITEHOUSE S.A.ION, N.J., Nov. 13, 2008 -(HSMN NewsFeed)--GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant], the cervical cancer vaccine from Merck & Co., Inc., prevented 90 percent of external genital lesions caused by human papillomavirus (HPV) types 6, 11, 16 and 18 in a pivotal Phase III study in men aged 16 to 26. These are the only data evaluating efficacy of any HPV vaccine in preventing diS.A.e in males, and were presented for the first time this week at the European ReS.A.ch Organization on Genital Infection and NeoplaS.A.(EUROGIN) International Multidisciplinary Conference.

The initial planned analysis of this study, an analysis of male study participantS.A.ed 16 to 26 who had not been infected with at least one of the four HPV types before the S.A.t of the study through one month after receiving their third dose of the vaccine or placebo, has been completed. ThiS.A.alysis was predetermined in the study protocol to be conducted after at least 32 cases of external genital lesions were observed. The study is ongoing, and additional data will be submitted to global regulatory agencies once available.

Merck remains on track to submit a supplemental Biologics License Application for GARDASIL to the U.S. Food and Drug Administration by the end of 2008 for the use of GARDASIL in boyS.A.d men ages 9 to 26 for the prevention of external genital lesions caused by HPV types 6, 11, 16 and 18. Other regulatory submissionS.A.ound the world will occur as planned.

GARDASIL is not currently approved for males in the United S.A.es. GARDASIL is indicated for use in girlS.A.d young women 9 through 26 years of age for the prevention of cervical, vulvar and vaginal cancers caused by HPV types 16 and 18; genital warts caused by HPV types 6 and 11; and precancerous or dysplastic lesions caused by HPV types 6, 11, 16 and 18.

GARDASIL Reduced External Genital Lesions in Males by 90 Percent

The placebo-controlled, Phase III study was designed to determine the efficacy of GARDASIL in maleS.A.ainst HPV 6, 11, 16, and 18-related external genital lesions, a composite endpoint that included: 1) genital warts (condylomata), 2) penile/perineal/perianal intraepithelial neoplaS.A.(or PIN; PIN 2/3 can be pre-cursors to cancer) and 3) penile/perineal/perianal cancer. Penile/perineal/perianal is defined as related to or affecting the penis (penile), the area between the anuS.A.d the scrotum (perineal), or the opening of the rectum to the outside of the body (perianal).

The study evaluated approximately 3,400 heterosexual males 16 through 23 years of age and approximately 600 men 16 to 26 years of age who have sex with men. Participants were randomized in a 1-to-1 ratio to receive either GARDASIL or placebo at day one, two monthS.A.d six months, with 36 months of planned follow-up from day one. At the time of vaccination, participants had no evidence of genital lesions, no history of genital wartS.A.d five or fewer lifetime sexual partners.

In the study, GARDASIL was 90.4 percent effective at reducing external genital lesions (3 cases in the vaccine group vs. 31 cases in placebo group; 95 percent CI: 69.2, 98.1, p-value <0.001). The three cases seen among those vaccinated with GARDASIL were cases of genital warts, resulting in GARDASIL being 89.4 percent effective in preventing genital warts (95 percent CI: 65.5, 97.9). For penile/perineal/perianal intraepithelial neoplaS.A.or PIN, there were no cases in the vaccine group vs. 3 cases of PIN 1 or PIN 2/3 in the placebo group. There were no cases of penile/perineal/perianal cancer in either vaccine or placebo group. At the time of thiS.A.alysis, the study had a mean duration of about 29 months.

No vaccine-related seriouS.A.verse events were reported in this study. A slightly higher proportion of study participants reported injection-site adverse events in the vaccine group compared to placebo (60.1 percent vs. 53.7 percent).

GARDASIL Also Achieved S.A.istical Significance on Both Secondary Endpoints

Two secondary endpointS.A.so were evaluated in this pivotal study and results from these analyses were presented at EUROGIN. GARDASIL was 85.6 percent effective at reducing persistent infection (15 cases in the vaccine group vs. 101 cases in the placebo group; 95 percent CI: 75.1, 92.2, p-value <0.001). Persistent infection is when the same HPV type is detected through S.A.s or biopsies over two or more consecutive visits six monthS.A.art. In addition, GARDASIL was 44.7 percent effective at reducing "anytime" HPV DNA detection (136 cases in the vaccine group vs. 241 cases in the placebo group; 95 percent CI: 31.5, 55.6, p-value <0.001). "Anytime" HPV DNA detection means HPV DNA is found through S.A.s or biopsieS.A. any visit; persistent infection iS.A.part of "anytime" HPV DNA detection.

Additional Important Information about GARDASIL

GARDASIL is contraindicated in individuals with hypersensitivity, including severe allergic reactions to yeast, or after a previous dose of GARDASIL.

The health care provider should inform the patient, parent or guardian that vaccination does not substitute for routine cervical cancer screening. Women who receive GARDASIL should continue to undergo cervical cancer screening.

GARDASIL is not recommended for use in pregnant women.

Vaccination with GARDASIL may not result in protection in all vaccine recipients. GARDASIL is not intended to be used for treatment of active genital warts, cervical, vaginal and vulvar cancers, cervical intraepithelial neoplaS.A.(CIN), vulvar intraepithelial neoplaS.A.(VIN) or vaginal intraepithelial neoplaS.A.(VaIN).

GARDASIL has not been demonstrated to provide protection against diS.A.e from vaccine and non-vaccine HPV types to which a woman has previously been exposed through sexual activity. GARDASIL has not been shown to protect against diS.A.es due to HPV types not contained in the vaccine.

Not all vulvar and vaginal cancerS.A.e caused by human papillomavirus (HPV), and GARDASIL protects only against those vulvar and vaginal cancers caused by HPV types 16 and 18.

The most common adverse reaction was headache. Common adverse reactions that were observed among recipients of GARDASIL at a frequency of at least 1.0 percent and greater than placebo were fever, nauS.A. dizziness; and injection-site pain, swelling, erythema, pruritus, and bruising.

In addition, syncope has been reported following vaccination with GARDASIL, sometimes resulting in falling with injury. Observation for 15 minuteS.A.ter administration is recommended.

Dosage and Administration for GARDASIL
GARDASIL iS.A.ready-to-use, three-dose, intramuscular vaccine. GARDASIL should be administered in three separate intramuscular injections in the deltoid region of the upper arm or in the higher anterolateral area of the thigh. The following dosage schedule is recommended: first dose at elected date, second dose two monthS.A.ter the first dose and the third dose six monthS.A.ter the first dose.

Human Papillomavirus: A Virus that Affects Both Men and Women
According to the Centers for DiS.A.e Control and Prevention, in the U.S. alone, an estimated 20 million men and women are currently infected with HPV, and another 6.2 million people become newly infected each year. For most, HPV goeS.A.ay on its own. However, certain low-risk types of HPV can cause external genital lesions. More than one million cases of external genital lesions in men and women occur each year in the U.S. and more than 30 million occur each year worldwide. In addition for women, certain high-risk types of HPV, if unrecognized and untreated, can lead to cervical cancer.

HPV iS.A.virus that can infect the genital region of men and women. There are an estimated 30 to 40 types of genital HPV. HPV transmission can happen with any kind of intimate genital contact with someone who has HPV; sexual intercourse is not needed. Most sexually active people will have HPV at some time in their lives.

Other Information about GARDASIL

In 1995, Merck entered into a license agreement and reS.A.ch collaboration with CSL Limited of Australia relating to technology used in GARDASIL. GARDASIL also is the subject of other third-party licensing agreements.

About Merck

Merck & Co., Inc. iS.A.global reS.A.ch-driven pharmaceutical company dedicated to putting patients first. ES.A.lished in 1891, Merck currently discovers, develops, manufactureS.A.d markets vaccineS.A.d medicines to address unmet medical needs. The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate Merck medicines but help deliver them to the people who need them. Merck also publishes unbiased health information aS.A.not-for-profit service. For more information, visit www.merck.com.

Forward-Looking S.A.ement

This press release contains "forward-looking S.A.ements" as that term is defined in the Private Securities Litigation Reform Act of 1995. These S.A.ementS.A.e based on management's current expectationS.A.d involve riskS.A.d uncertainties, which may cause results to differ materially from those set forth in the S.A.ements. The forward-looking S.A.ements may include S.A.ements regarding product development, product potential or financial performance. No forward-looking S.A.ement can be guaranteed and actual results may differ materially from those projected. Merck undertakes no obligation to publicly update any forward-looking S.A.ement, whether aS.A.result of new information, future events, or otherwise. Forward-looking S.A.ements in this press release should be evaluated together with the many uncertainties that affect Merck's business, particularly those mentioned in the risk factorS.A.d cautionary S.A.ements in Item 1A of Merck's Form 10-K for the year ended Dec. 31, 2007, and in any risk factors or cautionary S.A.ements contained in the Company's periodic reports on Form 10-Q or current reports on Form 8-K, which the Company incorporates by reference.

GARDASIL® iS.A.registered trademark of Merck & Co., Inc., Whitehouse S.A.ion, N.J., U.S.A.


Source: Merck

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