scholarly journals What to do when nothing else is left to be done - metastatic non-HPV vulvar squamous cell carcinoma with multiple lines of chemotherapy

2021 ◽  
Vol 8 (3) ◽  
pp. 50-55
Author(s):  
Mihaela Mărioara Stana ◽  
◽  
Sandra Deac ◽  
Călin Cainap ◽  
◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Anal Carcinoma ◽  
Vulvar Carcinoma ◽  
Vulvar Squamous Cell Carcinoma ◽  
Inguinal Lymphadenectomy ◽  
Advanced Cervical Carcinoma ◽  
Starting Point ◽  
Radical Vulvectomy

Recurrent vulvar squamous cell carcinoma with multiple site metastases is a rare entity – (up to 14.2% of the total number of recurrences), with a poor prognosis (only 15% of the patients alive at 5 years). Due to its “hard to find” character, there are no standardized guidelines available and the treatment is extrapolated from advanced cervical carcinoma, anal carcinoma and other squamous cell carcinomas. Immunotherapy has shown some positive results in vulvar carcinoma with PD-L1 positive, high TMB, high MSI or with MMR deficiency. An alternative for selected cases without therapeutic resources could be the HPV vaccine. We present the case of a 64-year-old woman diagnosed in 2014 with vulvar squamous cell carcinoma stage II for which she underwent radical vulvectomy with bilateral inguinal lymphadenectomy followed by external radiotherapy. In 2019 she developed local recurrence associated with lung, pleural, lymph nodes and subcutaneous metastasis, treated with three lines of chemotherapy: paclitaxel/carboplatin followed by cisplatin/5-fluorouracil and carboplatin/gemcitabine. The patient’s general health status altered progressively, and she died after the 4th cycle of carboplatin/gemcitabine. This case’s management could be a starting point for the vulvar carcinoma cases where the standard therapeutical options do not represent a choice anymore, providing the necessary example on how to approach it.

scholarly journals Invasive vulvar squamous cell carcinoma and chronic psoriasis

2018 ◽  
Vol 1 (1) ◽  
pp. 19-20
Author(s):  
Florica Șandru ◽  
Ana-Maria Păunescu ◽  
Mihai Cristian Dumitrașcu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Surgical Treatment ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Invasive Squamous Cell Carcinoma ◽  
Tumour Mass ◽  
Vulvar Carcinoma ◽  
Inguinal Lymphadenectomy ◽  
Labia Majora ◽  
Examination Result

 Vulvar carcinoma is the fourth most common gynecologic malignancy[1]. A 50 year old patient presented to us for evaluation of an infiltrated, ulcerated vulvar tumour mass, with irregular borders, localized on the left labia majora. Also, palms, soles and elbows presented typical psoriasis plaques .  The biopsy of the palmar tegument was concludent for vulgar psoriasis. The incisional vulvar biopsy revealed a squamous cell carcinoma. HPV testing was positive for HPV 16 infection with high-oncogenic risk. The CT scan showed the tumour located on the left labia majora, measuring 3 cm, with irregular borders and inguinal left node metastasis. The surgical treatment was partial vulvectomy with bilateral inguinal lymphadenectomy. The postoperatory course was good, with no local complications. Postoperative histological examination result was invasive squamous cell carcinoma, poorly differentiated(G3), basaloid, infiltrative(>1 mm, pT1b), with lymph node, ganglionar metastasis and capsular invasion(N2a). The surgical treatment was recommended to be followed by chemotherapy and radiotherapy. Our case highlights the aggresive, rapidly evolution of a squamocelular vulvar carcinoma in a patient with concomitantly chronic psoriasis.  Psoriasis is a disease that alters the immune system and increases overall inflammation, which can expand the risk of developing cancers.. There is a high risk for malignancy in psoriatic patients [2]. A study found a higher frequency of all malignity among the patients with psoriasis; also, the risk of nonmelanoma skin cancer was higher [3]. 

scholarly journals Description of the genetic variants identified in a cohort of patients diagnosed with localized anal squamous cell carcinoma and treated with panitumumab

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lucía Trilla-Fuertes ◽  
Angelo Gámez-Pozo ◽  
Joan Maurel ◽  
Rocio Garcia-Carbonero ◽  
Jaume Capdevila ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Clinical Practice ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Genetic Variants ◽  
Anal Carcinoma ◽  
Genetic Alterations ◽  
Daily Clinical Practice ◽  
Complete Regression ◽  
Anal Squamous Cell Carcinoma

AbstractSquamous cell carcinoma is the most frequent histologic type of anal carcinoma. The standard of care since the 1970s has been a combination of 5-fluorouracil, mitomycin C, and radiotherapy. This treatment is very effective in T1/T2 tumors (achieving complete regression in 80–90% of tumors). However, in T3/T4 tumors, the 3-year relapse free survival rate is only 50%. The VITAL trial aimed to assess the efficacy and safety of panitumumab in combination with this standard treatment. In this study, 27 paraffin-embedded samples from the VITAL trial and 18 samples from patients from daily clinical practice were analyzed by whole-exome sequencing and the influence of the presence of genetic variants in the response to panitumumab was studied. Having a moderate- or high-impact genetic variant in PIK3CA seemed to be related to the response to panitumumab. Furthermore, copy number variants in FGFR3, GRB2 and JAK1 were also related to the response to panitumumab. These genetic alterations have also been studied in the cohort of patients from daily clinical practice (not treated with panitumumab) and they did not have a predictive value. Therefore, in this study, a collection of genetic alterations related to the response with panitumumab was described. These results could be useful for patient stratification in new anti-EGFR clinical trials.

scholarly journals Exploring Differentially Methylated Genes in Vulvar Squamous Cell Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3580
Author(s):  
Shatavisha Dasgupta ◽  
Patricia C. Ewing-Graham ◽  
Sigrid M. A. Swagemakers ◽  
Thierry P. P. van den Bosch ◽  
Peggy N. Atmodimedjo ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Dna Sequences ◽  
Cpg Island ◽  
Epigenetic Modification ◽  
Vulvar Squamous Cell Carcinoma ◽  
Differentially Methylated Genes ◽  
Methylation Profiling

DNA methylation is the most widely studied mechanism of epigenetic modification, which can influence gene expression without alterations in DNA sequences. Aberrations in DNA methylation are known to play a role in carcinogenesis, and methylation profiling has enabled the identification of biomarkers of potential clinical interest for several cancers. For vulvar squamous cell carcinoma (VSCC), however, methylation profiling remains an under-studied area. We sought to identify differentially methylated genes (DMGs) in VSCC, by performing Infinium MethylationEPIC BeadChip (Illumina) array sequencing, on a set of primary VSCC (n = 18), and normal vulvar tissue from women with no history of vulvar (pre)malignancies (n = 6). Using a false-discovery rate of 0.05, beta-difference (Δβ) of ± 0.5, and CpG-island probes as cut-offs, 199 DMGs (195 hyper-methylated, 4 hypo-methylated) were identified for VSCC. Most of the hyper-methylated genes were found to be involved in transcription regulator activity, indicating that disruption of this process plays a vital role in VSCC development. The majority of VSCCs harbored amplifications of chromosomes 3, 8, and 9. We identified a set of DMGs in this exploratory, hypothesis-generating study, which we hope will facilitate epigenetic profiling of VSCCs. Prognostic relevance of these DMGs deserves further exploration in larger cohorts of VSCC and its precursor lesions.

scholarly journals Pembrolizumab in vaginal and vulvar squamous cell carcinoma: a case series from a phase II basket trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeffrey A. How ◽  
Amir A. Jazaeri ◽  
Pamela T. Soliman ◽  
Nicole D. Fleming ◽  
Jing Gong ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Phase Ii ◽  
Squamous Cell ◽  
Single Agent ◽  
Case Series ◽  
Predictive Biomarkers ◽  
Vulvar Squamous Cell Carcinoma ◽  
Metastatic Setting ◽  
Progression Of Disease

AbstractVaginal and vulvar squamous cell carcinoma (SCC) are rare tumors that can be challenging to treat in the recurrent or metastatic setting. We present a case series of patients with vaginal or vulvar SCC who were treated with single-agent pembrolizumab as part of a phase II basket clinical trial to evaluate efficacy and safety. Two cases of recurrent and metastatic vaginal SCC, with multiple prior lines of systemic chemotherapy and radiation, received pembrolizumab. One patient had significant reduction (81%) in target tumor lesions prior to treatment discontinuation at cycle 10 following confirmed progression of disease with new metastatic lesions (stable disease by irRECIST criteria). In contrast, the other patient with vaginal SCC discontinued treatment after cycle 3 due to disease progression. Both patients had PD-L1 positive vaginal tumors and tolerated treatment well. One case of recurrent vulvar SCC with multiple surgical resections and prior progression on systemic carboplatin had a 30% reduction in her target tumor lesions following pembrolizumab treatment with a PD-L1 positive tumor. Treatment was discontinued for grade 3 mucositis after cycle 5. Pembrolizumab may provide some clinical benefit to some patients with vaginal or vulvar SCC and is overall safe to utilize in this population. Future studies are needed to evaluate the efficacy of pembrolizumab in these rare tumor types and to identify predictive biomarkers of response.

The role of RhoA in vulvar squamous cell carcinoma: a carcinogenesis, progression, and target therapy marker

Tumor Biology ◽  
2015 ◽  
Vol 37 (3) ◽  
pp. 2879-2890 ◽  
Author(s):  
Jing Wang ◽  
Qiong Wu ◽  
Li-hua Zhang ◽  
Yun-xia Zhao ◽  
Xin Wu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Target Therapy ◽  
Vulvar Squamous Cell Carcinoma
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