Vulvar Cancer

Emerging data support the use of immune checkpoint inhibitors in squamous BGC and targeted agents (e.g., mTOR/CDK4/6 inhibitors) in adenocarcinoma. We propose a practical molecular testing algorithm and highlight the urgent need for prospective, multinational collaboration to establish BGC-specific guidelines.

Repurposed drugs with established safety and pharmacological profiles can accelerate therapeutic discovery; however, some regulatory and industry barriers remain. Coupled with advanced patient-centred technologies, 3D tumoroids, tumour-on-a-chip, and microfluidic systems, drug repurposing strategies promise to advance personalised medicine and improve survival outcomes for women with gynaecological malignancies.

It may be prudent to maintain increased vigilance for persistent vulvar lesions, particularly in HPV-negative and histologically ambiguous settings. Comprehensive assessment (including immunohistochemistry) may facilitate earlier detection and more accurate diagnosis, thereby potentially improving treatment outcomes.

P3, N=640, Not yet recruiting, Queensland Centre for Gynaecological Cancer | Phase classification: P2 --> P3 | N=240 --> 640 | Trial completion date: Apr 2029 --> Dec 2035 | Trial primary completion date: Apr 2027 --> Dec 2035

P1, N=32, Active, not recruiting, Baylor College of Medicine | Trial primary completion date: Oct 2025 --> Jan 2026

Management includes surgical excision with or without adjuvant therapy. Recognition of these unique neoplasms can aid in refining the classification scheme for such uncommon vulvar tumors.

These findings are hypothesis generating and provide rationale for future clinical trials of ADCs and immune checkpoint inhibitors in VSCC. Results suggest HPV-independent tumors may be immunogenically active.

P=N/A, N=111, Completed, Memorial Sloan Kettering Cancer Center | Recruiting --> Completed | N=1026 --> 111

This case illustrates the diagnostic complexity of EMPD metastasizing to an unusual site and highlights the critical role of cytomorphology, special stains, and immunohistochemistry in excluding alternate primaries. Mucicarmine staining highlighted abundant intracytoplasmic mucin, serving as a useful adjunct in raising suspicion for EMPD. While not specific, in conjunction with cytomorphology and immunohistochemistry, this supported EMPD over invasive ductal carcinoma of the breast. Given the rarity of such distant nodal metastases, a high index of suspicion should be maintained for EMPD in patients with a known history, even when metastases appear in non-regional lymph nodes.

P1, N=840, Active, not recruiting, TScan Therapeutics, Inc. | Recruiting --> Active, not recruiting

P=N/A, N=126, Not yet recruiting, City of Hope Medical Center

P=N/A, N=22, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Recruiting --> Active, not recruiting | N=40 --> 22