外阴癌免疫治疗进展★

Immunotherapy progress in vulvar cancer★

摘要:

外阴癌是较为罕见的妇科恶性肿瘤，最常见的组织学类型为鳞状细胞癌（VSCC）。VSCC可分为人乳头瘤病毒（HPV）相关型和HPV非相关型，二者生物学行为及预后有所不同。外阴癌的传统治疗方法包括手术、放疗和化疗，但晚期和复发患者预后不佳。以免疫检查点抑制剂（ICI）为主的免疫治疗，在多种实体瘤的治疗中取得了显著进展，并在外阴癌中初步显示出一定疗效。然而，由于外阴癌的罕见性，其免疫治疗数据多来自包含外阴癌患者的大型临床研究，预测疗效的生物标志物和最佳ICI治疗方案仍在探索中。此外，T细胞受体工程化T细胞（TCR-T）疗法等免疫治疗也在外阴癌中显示出潜在效益。本文综述了外阴癌常见免疫生物标志物表达情况、免疫治疗进展及与免疫治疗疗效相关的潜在标志物，旨在为外阴癌免疫治疗提供参考，推动其在临床应用中的发展。

Abstract:

Vulvar cancer is a relatively rare gynecologic malignancy, with vulvar squamous cell carcinoma (VSCC) being the most common histological subtype. VSCC can be categorized into human papillomavirus (HPV)-associated and HPV-independent types, with differences in biological behavior and prognosis. Traditional treatment for vulvar cancer includes surgery, radiotherapy, and chemotherapy; however, the prognosis for patients with advanced or recurrent disease remains poor. Immunotherapy, particularly immune checkpoint inhibitor (ICI), has shown significant progress in the treatment of various solid tumors and has demonstrated preliminary efficacy in vulvar cancer. However, due to the rarity of vulvar cancer, immunotherapy data are mostly derived from larger clinical studies that include vulvar cancer patients, and predictive biomarkers for efficacy, as well as optimal ICI treatment strategies, are still under investigation. Additionally, therapies such as T cell receptor-engineered T cells (TCR-T) have also shown potential benefits in vulvar cancer. This review summarizes the expression of common immune biomarkers, immunotherapy advances, and potential biomarkers associated with immune response in vulvar cancer, aiming to provide a reference for the immunotherapy of vulvar cancer and promote its development in clinical applications.