HPV-associated vulvar squamous cell carcinoma: lines of therapy
4 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Early stage (tumour under four centimetres, clinically negative groins) | Wide local excision with sentinel node biopsy (GROINSS-V I); groin radiotherapy for sentinel node metastases of two millimetres or less and lymphadenectomy for larger ones (GROINSS-V II). | NCCN Guidelines: Vulvar Cancer | 93 |
Locally advanced
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Locally advanced disease | Cisplatin-based chemoradiotherapy (GOG 205); surgery for residual disease; p16-positive tumours respond well. | NCCN Guidelines: Vulvar Cancer | 93 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Recurrent or metastatic disease | Carboplatin and paclitaxel with or without bevacizumab; pembrolizumab for PD-L1-positive or mismatch-repair-deficient tumours after chemotherapy; trials of pembrolizumab with lenvatinib and of cadonilimab. | NCCN Guidelines: Vulvar Cancer | 98 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Precursor (usual-type VIN) | Excision or laser ablation of visible lesions; imiquimod as a medical alternative; trials of artesunate ointment; HPV vaccination for prevention. | Thermal ablation and cryotherapy for cervical precancerHPV & HBV vaccinationNonavalent HPV vaccinePhase II Study of Artesunate Ointment for the Treatment of Vulvar High Grade Squamous Intraepithelial Lesions (Vulvar HSIL, VIN2/3)Evaluate the Efficacy, Immunogenicity and Safety of 9-valent HPV Recombinant Vaccine in Chinese Healthy Females | NCCN Guidelines: Vulvar Cancer | 86 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.