Successful treatment of metastatic vulvar malignant melanoma with toripalimab: A rare case report and review of the literature

Abstract

Rationale: Vulvar melanoma is a rare and aggressive tumor with a high risk of local recurrence and distant metastasis. The prognosis is poor with a 5-year overall survival rate of only 46.6%. Management of vulvar melanoma remains a clinical challenge. Recent evidences have shown that immune checkpoint inhibitors are effective in the treatment of vulvar melanoma.Patient concerns and diagnoses: A 63-year-old woman with vulvar malignant melanoma suffered inguinal lymph node metastasis after vulvectomy and chemotherapy. She underwent inguinal lymph node dissection and inguinal radiotherapy. The tumor progressed again and she received immunotherapy.Interventions: The tumor progressed again, and she was admitted to our hospital and received toripalimab combined with apatinib and abraxane.Outcomes: After 6 cycles of immunotherapy, the efficacy achieved partial remission. And with toripalimab as maintenance therapy, the patient achieved durable antitumor efficacy and good safety.Lessons: In this rare case, the patient with metastatic vulvar malignant melanoma had durable antitumor efficacy and good safety when receiving toripalimab.Abbreviations: CT = computed tomography, D1 = day 1, D2 = day 2, OS = overall survival, PD-1 = programmed cell death protein-1, q3w = once every 3 weeks, qd = quaque die, TRAEs = treatment-related adverse events.

Overall survival associated with surgery, radiotherapy, and chemotherapy in metastatic vulvar cancer: A retrospective cohort study based on the SEER database

“… 30 , 31 , 32 Previous studies have proposed that immune cells highly infiltrate vulvar tumor tissue, and clinical trials and case reports have confirmed the efficacy of immunotherapy in recurrent or metastatic vulvar cancer. 31 , 33 , 34 , 35 , 36 , 37 Therefore, personalized immunotherapy combined with radiotherapy or chemotherapy may be a promising treatment strategy for women with advanced vulvar cancer in the future. Vulvar malignant melanoma has unique characteristics, with different staging and treatment options than squamous carcinoma.…”

Primary Cutaneous Melanoma—Management in 2024

“…Toripalimab has a role similar to other PD-1 drugs managing melanomas. However, it has a particular further role in managing mucosal melanomas, including lip and vulva melanoma [ 108 , 109 , 110 , 111 , 112 ].…”