Vulvar cancer

Section editor
	Alaina J. Brown, MD, MPH Vanderbilt University Nashville, TN, USA LinkedIn

Last updated on 2024-07-23: 2 regimens on this page 2 variants on this page

Guidelines

Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.

ESGO

• 2023: Oonk et al. European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023 PubMed

NCCN

• NCCN Guidelines - Vulvar Cancer
  • 2024: Abu-Rustum et al. Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology PubMed
  • 2017: Koh et al. Vulvar Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology. PubMed

Neoadjuvant therapy

Cisplatin & RT

Cisplatin & RT: Cisplatin & Radiation Therapy

Regimen

Study	Dates of enrollment	Evidence
Moore et al. 2011	2005-01-19 to 2009-09-21	Phase 2

Chemotherapy

• Cisplatin (Platinol) 40 mg/m² IV once per day on days 1, 8, 15, 22, 29, 36, 43

Radiotherapy

• Concurrent radiation therapy 180 cGy per day on days 1 to 5, 8 to 12, 15 to 19, 22 to 26, 29 to 33, 36 to 40, 43, 44 (32 fractions, for a dose of 5760 cGy)

6.5-week course

Subsequent treatment

• Surgical resection of residual disease (or biopsy to confirm CR)

References

1. Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, Homesley HD, Walker JL. A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. Gynecol Oncol. 2012 Mar;124(3):529-33. Epub 2011 Nov 9. link to original article dosing details in abstract have been reviewed by our editors PubMed

Locally advanced or metastatic disease

Due to its relative rarity, there are very few prospective trials in advanced and metastatic vulvar cancer. In clinical practice, many adopt regimens from the cervical cancer literature; see the cervical cancer page for those regimens.

Paclitaxel monotherapy

Regimen

Study	Dates of enrollment	Evidence
Witteveen et al. 2009 (EORTC 55985)	2001-02 to 2004-12	Phase 2

Chemotherapy

• Paclitaxel (Taxol) 175 mg/m² IV once on day 1

21-day cycle for up to 10 cycles

References

1. EORTC 55985: Witteveen PO, van der Velden J, Vergote I, Guerra C, Scarabeli C, Coens C, Demonty G, Reed N; EORTC. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol. 2009 Sep;20(9):1511-6. Epub 2009 Jun 1. link to original article link to PMC article dosing details in manuscript have been reviewed by our editors PubMed