What's New in Vulvar Cancer Research and Treatment?

Vulvar cancer is rare, which makes it hard to study. Still, research is being done to find new ways to prevent and treat cancer of the vulva. There are some promising new developments.

Research on human papillomavirus and vulvar cancer

Vulvar squamous cell carcinoma (VSCC) is either human papillomavirus (HPV)-positive or HPV-negative. Most cases of VSCC are HPV-positive.  If it’s HPV-positive, the virus is thought to be the main cause of the vulvar cancer. If it’s HPV-negative, the cause of the cancer is unclear and can be due to many factors. 

Studies have looked at whether HPV affects how well vulvar cancer responds to treatment. So far, the results of these studies have been mixed. Researchers continue to ask the following questions:

• Do certain gene mutations cause HPV-negative vulvar cancer to develop? If so, can these mutations be targeted to treat the cancer?
• Does being HPV positive affect how well people with vulvar cancer respond to treatment?
• How can HPV-positive and HPV-negative vulvar cancers be treated differently to get the best outcomes?

Research on immunotherapy for vulvar cancer

Treatments used for vulvar cancer include immunotherapy drugs called checkpoint inhibitors. So far, they are generally only given to patients with metastatic or recurrent disease. Research continues to see if immunotherapy would work better with different combinations of chemo, or if it can be given for earlier-stage disease.

Research on targeted therapy for vulvar cancer

Current targeted therapy for vulvar cancer finds and destroys cancer cells with specific HER2 or NTRK mutations. Scientists are studying how specific drugs can target other gene mutations found in vulvar cancer cells. Oncogenes and tumor suppressor genes, which control cell growth, also are being studied.

Research on surgery for vulvar cancer

For early-stage vulvar cancer, the mainstay of treatment is surgery.  The goal is to remove all the cancer cells while leaving as many healthy cells as possible for cosmetic and functional purposes.  Clinical trials are being done to determine the best way to use and combine surgery, radiation therapy, and chemotherapy to achieve this goal.

Research on identifying (mapping) lymph nodes

Another area of interest is lymph node mapping. Vulvar cancer can spread to lymph nodes in the groin. Better ways to look for this spread and identify nodes with cancer might help doctors treat these nodes and decrease the risk of cancer coming back there. It could also allow them to save the healthy nodes and decrease the risk of long-term swelling in the groin and legs, called lymphedema.