title: Recurrent metastatic vulvar carcinoma treated with cisplatin plus cetuximab.
abstract: Recurrent vulvar carcinoma with metastasis has few effective treatment options, which are mainly directed toward palliation of symptoms. A 70-year-old woman was originally treated in 1999 for vulvar squamous cell carcinoma (SCC) with radical vulvectomy and bilateral inguinofemoral groin dissection. She represented in 2005 with a new lesion distinct from the margin of her first disease occurrence. Although treatment of this area included surgical resection and chemoradiation, she recurred 3 months later. Despite radical surgical resection with an anal perineal resection, she presented 2 months later with widely metastatic disease. Epidermal growth factor receptor (EGFR) staining of the tumor cells showed 3+ staining in 100% of the cells. She was treated with palliative radiation therapy (RT) and a cetuximab plus cisplatin chemotherapy protocol. A partial response was obtained for 5 months with palliation of symptoms. Few treatment options exist for recurrent metastatic vulvar carcinoma. The combination of the EGFR antagonist cetuximab with cisplatin has shown modest success in other metastatic SCCs. The partial response experienced in our patient suggests its potential use in women with recurrent or metastatic vulvar carcinoma.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Women's Hospital/University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. srichard@mail.magee.edu
authors.forename: S D
authors.initials: SD
authors.lastname: Richard
authors.forename: T C
authors.initials: TC
authors.lastname: Krivak
authors.forename: S
authors.initials: S
authors.lastname: Beriwal
authors.forename: K K
authors.initials: KK
authors.lastname: Zorn
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068818:Cetuximab; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068818:Cetuximab; D002945:Cisplatin