There is not one preferred second line agent for women with metastatic vulvar cancer who have progressed on carboplatin/paclitaxel. My preference is to put those patients on clinical trial, if possible. Next generation sequencing of the tumor could guide placement into a trial (such as MATCH or TAPU...

We generally extrapolate treatment of vulvar carcinoma from data on cervical cancer as both are lower genital tract HPV-associated cancers. Vulvar cancer is rare enough that randomized trials and even single arm phase II trials have not typically been done. Thus, I usually add bevacizumab to initial...