Neoadjuvant chemoimmunotherapy in HPV-associated vulvar and vaginal squamous cell carcinoma with PD-L1 CPS < 1:Dual pCR evidence.

BACKGROUND

While surgery and radiotherapy remain primary treatments for HPV-associated vulvar/vaginal squamous cell carcinoma (SCC), the significant complications and impaired quality of life underscore the need for alternative approaches. We report two cases achieving pathological complete response (pCR) with neoadjuvant chemoimmunotherapy.

CASES: Two biopsy-confirmed HPV-associated vulvar/vaginal SCC cases with inguinal lymph node metastases (both PD-L1 CPS < 1) received three cycles of neoadjuvant camrelizumab plus nab-paclitaxel/cisplatin. Subsequent imaging demonstrated marked tumor regression, permitting urethra-preserving resection. Histopathological analysis confirmed pCR, with no recurrence at 6-month follow-up.

CONCLUSION

Neoadjuvant chemoimmunotherapy may be an effective treatment for HPV-associated vulvar/vaginal SCC, potentially independent of PD-L1 CPS status, while improving post-treatment quality of life compared to conventional therapies.