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.