Cutaneous Melanoma versus Vulvovaginal Melanoma—Risk Factors, Pathogenesis and Comparison of Immunotherapy Efficacy

SIMPLE SUMMARY: Melanoma of the vulva and vagina is a relatively rare neoplasm, unlike melanoma of the skin. Its prognosis is poor, and its pathogenesis is not fully understood. Immunotherapy is one of the rapidly developing cancer treatment methods. In this article, we focus on the pathogenesis of lower genital tract melanomas and related risk factors and compare the effectiveness of two groups of drugs—anti-PD-L1 and anti-CTLA4 antibodies—in the treatment of this condition. This type of immunotherapy is a relatively common treatment method for cutaneous melanoma but not for the rare vulvovaginal melanoma. For vulvovaginal melanoma, the effects of these treatments appear to be limited; however, this requires further research. ABSTRACT: Cutaneous melanoma is a relatively common neoplasm, with fairly well understood pathogenesis, risk factors, prognosis and therapeutic protocols. The incidence of this disease is increasing every year. The situation is different for rare malignancies such as vulvar melanomas and for the even rarer vaginal melanomas. The risk factors for vulvovaginal tumors are not fully understood. The basis of treatment in both cases is surgical resection; however, other types of treatments such as immunotherapy are available. This paper focuses on comparing the pathogenesis and risk factors associated with these neoplasms as well as the efficacy of two groups of drugs—anti-PD-L1 and anti-CTLA4 inhibitors—against both cutaneous melanoma and melanoma of the lower genital tract (vulva and vagina). In the case of cutaneous melanoma, the situation looks more optimistic than for vulvovaginal melanoma, which has a much worse prognosis and, as it turns out, shows a poorer response to immune therapy.