HPV-independent vulvar squamous cell carcinoma (p53-mutant): lines of therapy
5 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 | Wide local excision with attention to margins, sentinel node biopsy or inguinofemoral lymphadenectomy by the GROINSS-V criteria; adjuvant radiotherapy for close margins or positive nodes. | NCCN Guidelines: Vulvar Cancer | 93 |
Locally advanced
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Locally advanced disease | Cisplatin chemoradiotherapy with surgery for residual disease; responses are less complete than in p16-positive tumours. | 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 tumours; 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 (differentiated VIN) and lichen sclerosus | Excision of differentiated VIN; long-term potent topical corticosteroids for lichen sclerosus; low threshold for biopsy of new lesions. | NCCN Guidelines: Vulvar Cancer | 77 | |
| All comers | Follow-up | Lifelong surveillance of the vulvar skin because new tumours arise in the lichen sclerosus field years later. | NCCN Guidelines: Vulvar Cancer | - |
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.