A case of recurrent vulvar carcinoma treated with erlotinib, an EGFR inhibitor.

BACKGROUND: There is no effective therapy for patients with regional and/or distant recurrence of vulvar carcinoma. Recently two case reports about the use of erlotinib, an EGFR (epithelial growth factor receptor) inhibitor, in the context of recurrent vulvar cancer were published with a good clinical response reported.

CASE: We report a case where erlotinib was used in a 67-year-old patient with recurrent and multi-treated vulvar carcinoma. Utilization of erlotinib was started with rapid clinical improvement. The treatment was well tolerated with palliation of symptoms. A CT scan also showed cutoff "net" improvement, with regression of size and number of hilar and pulmonary metastases. After one month of improvement, despite continuous treatment with erlotinib, dyspnea returned. A new CT scan showed an increased number of hilar nodes, a new hepatic lesion and increase in the size of the known pelvic lesion.

CONCLUSION: EGFR inhibitors appear to be promising agents for this devastating and fatal disease. As with other studies with these agents, our patient showed a rapid response with important palliation of symptoms, however of short duration.