Induction chemotherapy with cemiplimab in a patient with coexistent vulvar cancer and autoimmune disease: A case report

• Type of Material: Article
• Authors: Elizabeth G. Thayer, Emory University; Larissa Weirich, Emory University; Zoe Roecker, Emory University; Sara Brenner, Emory University; Jill Remick, Emory University; Ashish B. Patel, Emory University; Kristen D. Starbuck, Emory University
• Language: English
• Date: 2024-10
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2024 The Authors
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1016%2Fj.gore.2024.101487
• Title of Journal or Parent Work: Gynecologic Oncology Reports
• Volume: 55
• Start Page: 101487
• Keywords: cutaneous squamous cell carcinoma; cemiplimab; induction chemotherapy; vulvar cancer; immunotherapy; neoadjuvant chemotherapy
• Research Categories: Health Sciences, Oncology; Health Sciences, Immunology

Abstract

There is limited data regarding the use of immunotherapy for patients with vulvar squamous cell carcinoma and coexisting autoimmune disease. Cemiplimab is a PD-1 inhibitor approved for use in patients with locally advanced and metastatic cutaneous squamous cell carcinoma. However, little is known about its efficacy in the setting of vulvar cancer. We present a case of advanced vulvar squamous cell carcinoma treated with induction chemotherapy and immunotherapy with cemiplimab followed by definitive chemoradiation in the setting of multiple autoimmune diseases. She achieved a complete clinical response and experienced no worsening of her autoimmune conditions despite cessation of her immunosuppressants and initiating an immune checkpoint inhibitor. We review existing data on neoadjuvant treatment of vulvar cancer and the use of cemiplimab in genital and inguinal squamous cell carcinomas. Ongoing exploration of cemiplimab’s efficacy in vulvar cancer and safety in immunosuppressed patients is critical.