Targeted Therapeutic Approaches in Vulvar Squamous Cell Cancer (VSCC)

TY - JOUR

T1 - Targeted Therapeutic Approaches in Vulvar Squamous Cell Cancer (VSCC)

AU - Woelber, Linn

AU - Mathey, Sabrina

AU - Prieske, Katharina

AU - Kuerti, Sascha

AU - Hillen, Christoph

AU - Burandt, Eike

AU - Coym, Anja

AU - Mueller, Volkmar

AU - Schmalfeldt, Barbara

AU - Jaeger, Anna

PY - 2021/3/16

Y1 - 2021/3/16

N2 - 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 20132019 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 25)]. 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 26 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 413 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 34 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.

AB - 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 20132019 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 25)]. 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 26 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 413 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 34 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.

KW - Adult

KW - Aged

KW - Antibodies, Monoclonal, Humanized/therapeutic use

KW - Antineoplastic Agents/therapeutic use

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Bevacizumab/therapeutic use

KW - Carcinoma, Squamous Cell/drug therapy

KW - ErbB Receptors/metabolism

KW - Erlotinib Hydrochloride/therapeutic use

KW - Female

KW - Humans

KW - Immunotherapy/methods

KW - Middle Aged

KW - Neoplasm Metastasis

KW - Neoplasm Recurrence, Local

KW - Retrospective Studies

KW - Treatment Outcome

KW - Vascular Endothelial Growth Factor A/metabolism

KW - Vulvar Neoplasms/drug therapy

U2 - 10.3727/096504020X16076861118243

DO - 10.3727/096504020X16076861118243

M3 - SCORING: Review article

C2 - 33308371

VL - 28

SP - 645

EP - 659

JO - ONCOL RES

JF - ONCOL RES

SN - 0965-0407

IS - 6

ER -