Pigmented vulvar lesions affect 10% of all women. Fortunately, the vast majority of them are benign, although 1% of all melanomas in women involve the vulva. While the death rate for cutaneous melanoma has decreased by 7% each year over the previous five years, the prognosis for vulvar melanoma remains poor: the 5-year overall survival rate is 47%, compared to 92 per cent for cutaneous melanoma. The existing data indicate that this is most likely due to a combination of delayed diagnosis and differences in tumour biology, treatment methods, and treatment response. Despite the fact that many pivotal studies on checkpoint inhibitors included mucosal and vulvar melanomas, the data were frequently not reported separately. Post-hoc analyses show that overall response rates for checkpoint inhibitors range between 19 and 37 per cent. 

A newly published retrospective research on vulvar melanomas found an objective response in 33.3 per cent of cases, with a safety profile similar to that of cutaneous melanoma. If a c-KIT mutation is present, tyrosine kinase inhibitors may be explored in recurrent illness.

Reference: https://link.springer.com/article/10.1007/s40257-021-00614-7