New treatment standards for vulvar cancer 2020

TY - JOUR

T1 - New treatment standards for vulvar cancer 2020

AU - Woelber, Linn

AU - Jaeger, Anna

AU - Prieske, Katharina

PY - 2020/2

Y1 - 2020/2

N2 - PURPOSE OF REVIEW: To highlight the recent advances regarding molecular mechanisms and therapeutic strategies in vulvar squamous cell carcinoma (VSCC), a rare but continuously rising disease.RECENT FINDINGS: Clinical research focuses on deescalation especially with regard to surgery. Recurrence patterns have been analyzed to further understand the course of disease showing a persistent risk for local recurrence even several years after the initial diagnosis. The main focuses of recent translational research are the distinct molecular mechanisms behind human papillomavirus (HPV)-positive and -negative VSCC. Next-generation sequencing analyses have highlighted TP53 as central driver mutation in HPV-negative disease. For HPV-independent VSCC, an impaired prognosis with limited disease-free and overall survival has been reported from a large multicenter analysis. Although no targeted agent has been granted approval, the impact of immunotherapy in vulvar cancer has been investigated in basket trials. Therapy response, however, was limited.SUMMARY: Further clinical research should focus on deciphering the molecular mechanisms of tumor development further. Detailed understanding of the molecular landscape will help to find novel therapy targets, fight the disease in advanced stages and thereby improve the quality of life for affected patients.

AB - PURPOSE OF REVIEW: To highlight the recent advances regarding molecular mechanisms and therapeutic strategies in vulvar squamous cell carcinoma (VSCC), a rare but continuously rising disease.RECENT FINDINGS: Clinical research focuses on deescalation especially with regard to surgery. Recurrence patterns have been analyzed to further understand the course of disease showing a persistent risk for local recurrence even several years after the initial diagnosis. The main focuses of recent translational research are the distinct molecular mechanisms behind human papillomavirus (HPV)-positive and -negative VSCC. Next-generation sequencing analyses have highlighted TP53 as central driver mutation in HPV-negative disease. For HPV-independent VSCC, an impaired prognosis with limited disease-free and overall survival has been reported from a large multicenter analysis. Although no targeted agent has been granted approval, the impact of immunotherapy in vulvar cancer has been investigated in basket trials. Therapy response, however, was limited.SUMMARY: Further clinical research should focus on deciphering the molecular mechanisms of tumor development further. Detailed understanding of the molecular landscape will help to find novel therapy targets, fight the disease in advanced stages and thereby improve the quality of life for affected patients.

KW - Carcinoma, Squamous Cell/genetics

KW - Female

KW - High-Throughput Nucleotide Sequencing

KW - Humans

KW - Neoplasm Recurrence, Local/genetics

KW - Papillomaviridae

KW - Vulvar Neoplasms/genetics

U2 - 10.1097/GCO.0000000000000595

DO - 10.1097/GCO.0000000000000595

M3 - SCORING: Review article

C2 - 31876635

VL - 32

SP - 9

EP - 14

JO - CURR OPIN OBSTET GYN

JF - CURR OPIN OBSTET GYN

SN - 1040-872X

IS - 1

ER -