1. Targeted Therapeutic Approaches in Vulvar Squamous Cell Cancer (VSCC): Case Series and Review of the Literature
- Author
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Sabrina Mathey, Barbara Schmalfeldt, Eike Burandt, Volkmar Mueller, Anja Coym, Sascha Kuerti, Katharina Prieske, Anna Jaeger, Christoph Hillen, and Linn Woelber
- Subjects
0301 basic medicine ,Oncology ,Vascular Endothelial Growth Factor A ,Cancer Research ,medicine.medical_treatment ,Pembrolizumab ,Targeted therapy ,Vulvar cancer (VC) ,0302 clinical medicine ,Maintenance therapy ,Antineoplastic Combined Chemotherapy Protocols ,Neoplasm Metastasis ,Vulvar Neoplasms ,VEGF signaling pathway ,General Medicine ,Middle Aged ,Bevacizumab ,ErbB Receptors ,Treatment Outcome ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,Erlotinib ,Immunotherapy ,medicine.drug ,Adult ,medicine.medical_specialty ,Antineoplastic Agents ,Antibodies, Monoclonal, Humanized ,Article ,03 medical and health sciences ,Erlotinib Hydrochloride ,Internal medicine ,medicine ,Humans ,Radical surgery ,EGFR targeting ,Aged ,Retrospective Studies ,business.industry ,Immuno-oncology ,Vulvar cancer ,medicine.disease ,Radiation therapy ,030104 developmental biology ,Neoplasm Recurrence, Local ,business - Abstract
Therapeutic options in recurrent or metastasized vulvar squamous cell cancer (VSCC) not amenable to radiotherapy or radical surgery are limited. Evidence for the use of targeted therapies is sparse. All patients with VSCC treated at the Gynecological Cancer Center Hamburg-Eppendorf 2013–2019 were retrospectively evaluated for targeted therapeutic approaches. Furthermore, a MEDLINE, EMBASE, Web of Science, Scopus, and OVID database search was performed using the terms: “vulvar cancer” AND “targeted therapy,” “erlotinib,” “EGFR,” “bevacizumab,” “VEGF,” “pembrolizumab,” or “immunotherapy.” Twelve of 291 patients (4.1%) with VSCC received at least one targeted therapy at our institution. Previously, one or more platinum-based chemotherapy was applied to all patients [median 3.5 previous lines (range 2–5)]. In the erlotinib subgroup, two of five patients (40%) achieved stable disease (SD), while two patients (2/5, 40%) experienced partial response (PR). Treatment was given as monotherapy in second/third line for a median of 3.4 months (range 2–6 months). Bevacizumab (n = 9) was given as maintenance therapy after platinum-based first-line chemotherapy (9/9); best response was complete response (CR) (n = 2/9 22.2%). Median duration of treatment was 7 months (range 4–13 months) with two patients still under ongoing treatment. Best response in the pembrolizumab (n = 3) subset was SD (n = 1/3 33%). Treatment was given as monotherapy in second/third line for a median of 3.3 months (range 3–4 months). Nine of 12 patients (75%) experienced treatment-related adverse events (TRAEs), most commonly grade 1/2. Rapidly evolving antibody treatments have proven clinical benefit especially in HPV-driven tumor entities; however, clinical investigations in VSCC are still limited. These reported cases provide evidence for the clinical utility and feasibility while ensuring an acceptable safety profile.
- Published
- 2021