Evidence map›Paper›PMID 34234460›Full record

ArticleOncoTargets and therapy2021

PD-L1 Expressing Recurrent Clear Cell Carcinoma of the Vulva with Durable Partial Response to Pembrolizumab: A Case Report.

Manavi Sachdeva, Natalie Y L Ngoi, Diana Lim, Michelle L M Poon, Yee Liang Thian, Yi Wan Lim, Siew Eng Lim, Pearl Tong, Jeffrey H Y Lum, Joseph Ng and 4 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in OncoTargets and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 2 countries.

Manavi SachdevaDepartment of Medicine, National University Health System Singapore, Singapore, 119074, Singapore.
Natalie Y L NgoiDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, 119228, Singapore.ORCID 0000-0003-2071-0715
Diana LimDepartment of Pathology, National University Health System Singapore, Singapore, 119074, Singapore.
Michelle L M PoonDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, 119228, Singapore.
Yee Liang ThianDepartment of Diagnostic Imaging, National University Health System Singapore, Singapore, 119074, Singapore.
Yi Wan LimDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, 119228, Singapore.ORCID 0000-0003-4823-5151
Siew Eng LimDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, 119228, Singapore.
Pearl TongDivision of Gynecology-Oncology, Department of Obstetrics and Gynecology, National University Hospital Singapore, Singapore, 119074, Singapore.
Jeffrey H Y LumDepartment of Pathology, National University Health System Singapore, Singapore, 119074, Singapore.
Joseph NgDivision of Gynecology-Oncology, Department of Obstetrics and Gynecology, National University Hospital Singapore, Singapore, 119074, Singapore.
Arunachalam IlancheranDivision of Gynecology-Oncology, Department of Obstetrics and Gynecology, National University Hospital Singapore, Singapore, 119074, Singapore.
Efren J DomingoDepartment of Obstetrics and Gynecology, University of the Philippines College of Medicine, Philippine General Hospital, Manila, 1000, Metro Manila, Philippines.
Jeffrey J H LowDivision of Gynecology-Oncology, Department of Obstetrics and Gynecology, National University Hospital Singapore, Singapore, 119074, Singapore.ORCID 0000-0002-1992-7389
David S P TanDepartment of Hematology-Oncology, National University Cancer Institute, Singapore, 119228, Singapore.ORCID 0000-0001-9087-5262
National University Cancer Institute, Singapore · SGNational University Health System · SGNational University Hospital · SGNational University of Singapore · SGPhilippine General Hospital · PH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal treatment and molecular landscape of recurrent clear cell carcinoma of the vulva (VCCC) are unknown. No reported data exist regarding the efficacy of anti-programmed death 1 (PD-1) immune checkpoint inhibition in VCCC. We report on a patient with chemotherapy-refractory recurrent VCCC, who was found to have high tumor programmed death-ligand 1 (PD-L1) combined positive score (CPS), and subsequently experienced a durable partial response (PR), after treatment with off-label fifth-line pembrolizumab. CASE PRESENTATION: A forty-year-old Filipino woman presented to our center with recurrent VCCC that had progressed on multiple prior lines of cytotoxic chemotherapy. She had a large 25 cm fungating left groin tumor causing marked lower limb lymphedema, pain and limited mobility. PD-L1 CPS by immunohistochemistry was 45. She was treated with off-label pembrolizumab monotherapy and had a dramatic clinical, biochemical and radiological partial response. The progression-free survival of this patient's VCCC after treatment with pembrolizumab, defined as the time from initiation of pembrolizumab until disease progression (by Response Evaluation Criteria in Solid Tumors (version 1.1)), was 8 months. While receiving pembrolizumab, she was diagnosed with concurrent secondary myelodysplastic syndrome with excess blasts (MDS-EB), thought to be related to her prior exposure to multiple lines of cytotoxic chemotherapy. This eventually progressed to acute myeloid leukemia (AML), leading to her demise. Overall survival from time of initiation of pembrolizumab till death was 16 months.

conclusionPembrolizumab was active in this patient with chemotherapy-refractory VCCC which harbored high PD-L1 CPS. Further studies to determine the role of immune check-point blockade in the treatment of VCCC are warranted.

Indexed as

clear cell carcinomaimmune check-point blockadeimmunotherapyvulvar cancer

Identifiers

PMID34234460
PMCPMC8254584
OpenAlexW3177272644

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.