Praiss Aaron, Navitski Anastasia, Cohen Seth, Tessier-Cloutier Basile, Broach Vance, O'Cearbhaill Roisin E
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Gynecol Oncol Rep. 2022 Apr 19;41:100982. doi: 10.1016/j.gore.2022.100982. eCollection 2022 Jun.
There are limited treatment options for patients with advanced vulvar cancer. However, several immune checkpoint inhibitors (ICIs) are FDA-approved or NCCN-Compendia-listed for qualified patients with advanced disease. In this case report, we present a patient with metastatic vulvar squamous cell carcinoma who was treated with pembrolizumab in the setting of disease progression following prior treatment with radiation and chemotherapy. Best response to immunotherapy was an unconfirmed partial response. We summarize the current role of ICIs in treating advanced vulvar cancer, which is largely extrapolated from the squamous cell skin cancer and cervical cancer guidelines. Additionally, we emphasize the need for more inclusive clinical trials and a better understanding of vulvar cancer molecular biology, as well as the identification of biomarkers to predict response to targeted therapy in patients with advanced vulvar cancer.
对于晚期外阴癌患者，治疗选择有限。然而，有几种免疫检查点抑制剂已获美国食品药品监督管理局（FDA）批准或被列入美国国立综合癌症网络（NCCN）的《综合癌症护理指南》，适用于符合条件的晚期疾病患者。在本病例报告中，我们介绍了一名转移性外阴鳞状细胞癌患者，该患者在先前接受放疗和化疗后疾病进展的情况下接受了帕博利珠单抗治疗。免疫治疗的最佳反应为未经证实的部分缓解。我们总结了免疫检查点抑制剂在治疗晚期外阴癌中的当前作用，这在很大程度上是从皮肤鳞状细胞癌和宫颈癌指南推断而来的。此外，我们强调需要开展更具包容性的临床试验，更好地了解外阴癌分子生物学，以及识别预测晚期外阴癌患者对靶向治疗反应的生物标志物。
