Ronnie Shapira-Frommer, MD, on Next Steps for Exploring Pembrolizumab Monotherapy in Patients With Vulvar Squamous Cell Carcinoma

CancerNetwork® sat down with Ronnie Shapira-Frommer, MD, to discuss the next steps for research into pembrolizumab monotherapy as a treatment option for patients with previously treated vulvar squamous cell carcinoma.

In a presentation at the Society of Gynecological Oncology (SGO) 2021 Virtual Annual Meeting on Women’s Cancer, Shapira-Frommer presented data from a cohort of patients with vulvar cancer who were treated in the phase 2 KEYNOTE-158 trial (NCT02628067), showing responses were achievable with pembrolizumab in this patient subgroup.

Transcription:

This is a very complicated study to enroll this cohort of patients. Vulvar cancer is a rare cancer. Patients are usually elderly, with low performance status or at least highly symptomatic [burden] because of the pelvic disease. Sometimes it’s difficult to evaluate because of the nature of spread, which is many times regional or local and invading the soft tissue of the pelvis. Usually, [performance status] deteriorates rapidly.

It is a major achievement to have a large cohort of this study and I believe that for some of the patients with metastatic vulvar cancer, this might be an option for treatment. Of course, we have to investigate deeper [regarding] patients that may respond to immunotherapy and also to explore combinations of immunotherapy—maybe [with other immunotherapeutics], TKIs [tyrosine kinase inhibitors], or anti-VEGF—and of course to explore mechanisms of response and resistance to immunotherapy. Thinking of a phase 3 study is more difficult because of the rarity of disease and because of the nature of patients who [often] have many comorbidities. I believe that further exploration of different combinations of treatment in phase 2 studies are the future looking forward for treatment of vulvar cancer.

References

Frommer RS, Mileshkin L, Manzyuk L, et al. Pembrolizumab for Vulvar Squamous Cell Carcinoma: Results From the Phase 2 KEYNOTE-158 Study. Abstract presented at: Society of Gynecological Oncology 2021 Virtual Annual Meeting on Women’s Cancer; March 19-21, 2021; Virtual. Abstract 11603.