Phase II trial of erlotinib in women with squamous cell carcinoma of the vulva

Horowitz, Neil S.; Olawaiye, Alexander; Borger, Darrell R.; Growdon, W.B.; Krasner, Carolyn; Matulonis, Ursula A.; Liu, J.F.; Lee, J.; Brard, Laurent; Dizon, Don S.

doi:10.1016/j.ygyno.2012.06.028

Cited by 85 publications

(52 citation statements)

References 34 publications

(43 reference statements)

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“…Nevertheless, the duration of responses was relatively short, and grade 3 to 4 toxicity was observed and included diarrhea (7.5%), acute renal failure (5%), and electrolyte abnormalities (5%). 33 Vascular endothelial growth factor is an attractive target in vulvar cancer given the good results observed with bevacizumab in women with recurrent cervical cancer. 34 As cervical cancer is a disease associated with human papillomavirus (HPV) infection in almost all cases, it is estimated that approximately 40% of vulvar cancer are also linked to HPV.…”

Section: Future Directionsmentioning

confidence: 99%

Treatment of Inoperable Vulvar Cancer: Where We Come From and Where Are We Going

Martínez-Castro

Poveda²,

Guinot³

et al. 2016

Int J Gynecol Cancer

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Vulvar cancer is a rare disease affecting elderly women that is commonly treated with surgery, radiation, and chemotherapy. When tumors compromise the urethra and the anus, or when it is in the groin lymph nodes, radiotherapy, chemotherapy, or both are necessary after surgery.The treatment of locally advanced vulvar cancer has suffered significant changes though the recent decades. So far, the best sequence of treatment is not known: surgery, chemotherapy, or radiotherapy. The radical surgeries usually need a long recovery term both in the region of the vulva and in the area of the groin lymph nodes. When it is performed, convalescence can delay other treatments, such as radiotherapy and chemotherapy. On the other hand, the use of radiotherapy and chemotherapy as a first step treatment can result in a complete elimination of the disease in at least 30% of the cases or substantial reduction of its size, allowing less extensive surgery. Therefore, the historical evolution of locally advanced vulvar cancer is reviewed.

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Section: Future Directionsmentioning

confidence: 99%

Treatment of Inoperable Vulvar Cancer: Where We Come From and Where Are We Going

Martínez-Castro

Poveda²,

Guinot³

et al. 2016

Int J Gynecol Cancer

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“…In this context, the use of the anti-EGFR tyrosine kinase inhibitor erlotinib showed promising results in selected cases [Olawaiye et al 2007]. More recently, the first phase II trial evaluating erlotinib for the management of vulvar cancer has been published by Horowitz and colleagues observing an overall clinical benefit rate of 67.5% with moderate but acceptable toxicity [Horowitz et al 2012]. However, this benefit was of only short duration so that the application of erlotinib in clinical routine should currently be reserved for special clinical indications.…”

Section: Systemic Treatment For Advanced or Metastatic Vulvar Cancermentioning

confidence: 99%

Management of patients with vulvar cancer: a perspective review according to tumour stage

et al. 2013

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Treatment of patients with vulvar cancer is challenging for gynaecologic oncologists. Owing to the localization in a sensitive area, surgical radicality and the indication for adjuvant treatment have to be balanced with psychosocial aspects to treat patients adequately. Clinical management is therefore highly dependent on the tumour stage. For patients with early-stage disease (FIGO I-II) therapy mainly concentrates on surgery with resection of the primary tumour and staging of the groin lymph nodes. In intermediate-stage vulvar cancer (FIGO III), advanced disease is expressed by affected inguinofemoral lymph nodes bringing radical lymphadenectomy and adjuvant therapy as well as radiation or chemoradiation into the focus of treatment. For locally advanced or metastatic vulvar cancer (FIGO IV) neoadjuvant or definitive chemoradiation has to be considered besides surgery. Owing to the low incidence of the disease, the level of evidence for different treatment modalities is poor. This review therefore puts different recommendations of clinical management in context and highlights the need for future trials.

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“…This agent is an anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor. While partial response was noted in 27%, the progression-free survival was only 13 weeks and toxicity was significant [19]. A patient with Stage IIIB vulvar carcinoma, positive for EGFR, was treated with cetuximab, a monoclonal antibody to EGFR, with prolonged clinical response [20].…”

Section: Discussionmentioning

confidence: 99%

Pembrolizumab in Recurrent Squamous Cell Carcinoma of the Vulva: Case Report and Review of the Literature

Shields

Gordinier

2018

Gynecol Obstet Invest

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Advanced vulvar cancer is associated with a very poor prognosis. Surgical resection is the mainstay of treatment, with radiation indicated for areas at high risk for recurrence. When surgical and radiation options have been exhausted, the effectiveness of systemic chemotherapy is poor. No biologic or targeted agents have been approved for the management of advanced or recurrent vulvar cancer. Pembrolizumab, a humanized monoclonal antibody against programmed death 1 (PD-1), has been successfully used as a target of tumor immune therapy in small cell lung cancer and melanoma. We present the first case in the literature of a patient with recurrent vulvar cancer who was treated successfully with pembrolizumab. Caris next-generation testing revealed a PD-L1 and PD-1 mutation (PD-L1 positive, 2+, 100%). She attained a complete clinical remission after 2 cycles, and a CT scan after 6 cycles revealed a significant response by RECIST criteria. After completing 10 cycles, treatment was stopped due to complications of severe malnutrition related to narcotic abuse. A CT scan 10 weeks after the final treatment revealed no adenopathy. Pembrolizumab is a safe and effective chemotherapeutic agent to treat recurrent vulvar carcinoma.

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Phase II trial of erlotinib in women with squamous cell carcinoma of the vulva

Cited by 85 publications

References 34 publications

Treatment of Inoperable Vulvar Cancer: Where We Come From and Where Are We Going

Treatment of Inoperable Vulvar Cancer: Where We Come From and Where Are We Going

Management of patients with vulvar cancer: a perspective review according to tumour stage

Pembrolizumab in Recurrent Squamous Cell Carcinoma of the Vulva: Case Report and Review of the Literature

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