The actual role of chemotherapy in vulvar cancer is undeniably a niche topic. The low incidence of the disease limits the feasibility of randomized trials. Decision making is thus oriented by clinical and pathological features, whose relevance is generally weighted against evidence from observational studies and clinical practice. The therapeutic management of vulvar cancer is increasingly codified and refined at an individual patient level. It is of note that the attitude towards evidence sharing and discussion within a multidisciplinary frame is progressively consolidating. Viable options included in the therapeutic armamentarium available for vulvar cancer patients are frequently an adaption from standards used for cervical or anal carcinoma. Chemotherapy is more frequently combined with radiotherapy as neo-/adjuvant or definitive treatment. Drugs commonly used are platinum derivative, 5-fluorouracil and mitomicin C, mostly in combination with radiotherapy for radiosensitization. Exclusive chemotherapy in the neo-/adjuvant setting comprises platinum-derivative, combined with bleomicin and methotrexate, 5-fluorouracil, ifosfamide or taxanes. In advanced disease, current regimens include cisplatin-based chemoradiation, with or without 5-fluorouracil, or doublets with platinum in combination with a taxane. Our work is also enriched by a concise excursus on the biologic pathways underlying vulvar cancer. Introductory hints are also provided on targeted agents, a rapidly evolving research field.

Role of chemotherapy in vulvar cancers: time to rethink standard of care? / Mazzotta, Marco; Pizzuti, Laura; Krasniqi, Eriseld; DI LISA, FRANCESCA SOFIA; Cappuzzo, Federico; Landi, Lorenza; Sergi, Domenico; Pelle, Fabio; Cappelli, Sonia; Botti, Claudio; Vizza, Enrico; Tomao, Silverio; Marchetti, Luca; Sanguineti, Giuseppe; Botticelli, Andrea; Marchetti, Paolo; Magri, Valentina; Pisegna, Simona; Venuti, Aldo; Tomao, Federica; Buzzacchino, Federica; Ciliberto, Gennaro; Barba, Maddalena; Vici, Patrizia. - In: CANCERS. - ISSN 2072-6694. - 13:16(2021). [10.3390/cancers13164061]

Role of chemotherapy in vulvar cancers: time to rethink standard of care?

Marco Mazzotta
Co-primo
;
Laura Pizzuti
Co-primo
;
Francesca Sofia Di Lisa;Silverio Tomao;Luca Marchetti;Andrea Botticelli;Paolo Marchetti;Valentina Magri;Simona Pisegna;Federica Buzzacchino;
2021

Abstract

The actual role of chemotherapy in vulvar cancer is undeniably a niche topic. The low incidence of the disease limits the feasibility of randomized trials. Decision making is thus oriented by clinical and pathological features, whose relevance is generally weighted against evidence from observational studies and clinical practice. The therapeutic management of vulvar cancer is increasingly codified and refined at an individual patient level. It is of note that the attitude towards evidence sharing and discussion within a multidisciplinary frame is progressively consolidating. Viable options included in the therapeutic armamentarium available for vulvar cancer patients are frequently an adaption from standards used for cervical or anal carcinoma. Chemotherapy is more frequently combined with radiotherapy as neo-/adjuvant or definitive treatment. Drugs commonly used are platinum derivative, 5-fluorouracil and mitomicin C, mostly in combination with radiotherapy for radiosensitization. Exclusive chemotherapy in the neo-/adjuvant setting comprises platinum-derivative, combined with bleomicin and methotrexate, 5-fluorouracil, ifosfamide or taxanes. In advanced disease, current regimens include cisplatin-based chemoradiation, with or without 5-fluorouracil, or doublets with platinum in combination with a taxane. Our work is also enriched by a concise excursus on the biologic pathways underlying vulvar cancer. Introductory hints are also provided on targeted agents, a rapidly evolving research field.
vulvar cancer; chemotherapy; gynecologic cancer
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Role of chemotherapy in vulvar cancers: time to rethink standard of care? / Mazzotta, Marco; Pizzuti, Laura; Krasniqi, Eriseld; DI LISA, FRANCESCA SOFIA; Cappuzzo, Federico; Landi, Lorenza; Sergi, Domenico; Pelle, Fabio; Cappelli, Sonia; Botti, Claudio; Vizza, Enrico; Tomao, Silverio; Marchetti, Luca; Sanguineti, Giuseppe; Botticelli, Andrea; Marchetti, Paolo; Magri, Valentina; Pisegna, Simona; Venuti, Aldo; Tomao, Federica; Buzzacchino, Federica; Ciliberto, Gennaro; Barba, Maddalena; Vici, Patrizia. - In: CANCERS. - ISSN 2072-6694. - 13:16(2021). [10.3390/cancers13164061]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1585341
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