Supplementary Material for: Pembrolizumab in vaginal carcinoma: a case report and review of the literature

Introduction. Vaginal cancer is a rare gynecologic malignancy. While in the localized disease
concurrent chemoradiation grants local control and better overall survival (OS), in the metastatic
setting the management options are very limited. Furthermore, recurrent cervical, vulvar, and
vaginal carcinomas notoriously develop resistance to treatment and consequently their prognosis
is still poor.
Case presentation. We herein present the case of a woman with nodal relapse of vaginal
carcinoma, effectively treated with third-line immunotherapy. We will also provide a review of the
literature on the new therapeutic strategies for advanced vaginal carcinoma with focus on
pembrolizumab immunotherapy.
Conclusion. Pembrolizumab might represent a promising option for the management of vaginal
and vulvar cancer, but data to support its use in this setting are still lacking. This case highlights
the need of further investigation and trial designs for this rare disease.

引言：阴道癌是一种罕见的妇科恶性肿瘤。对于局限性阴道癌患者，同步放化疗可实现局部控制并改善总生存期（overall survival, OS）；但在转移性疾病场景中，临床治疗选择极为有限。此外，复发的宫颈癌、外阴癌及阴道癌往往会产生治疗耐药性，因此患者预后仍然较差。
病例报告：本文报告1例阴道癌淋巴结复发患者，经三线免疫治疗后获得有效临床缓解。同时，本文还将综述晚期阴道癌新型治疗策略的相关文献，重点聚焦帕博利珠单抗（pembrolizumab）免疫治疗。
结论：帕博利珠单抗或许可为阴道癌与外阴癌的临床管理提供颇具前景的治疗选择，但目前仍缺乏支持其用于此类病症的相关临床数据。本病例凸显了针对这类罕见疾病开展进一步研究与临床试验设计的必要性。