Immunotherapy for Vaginal Cancer
Immunotherapy uses medicines to help a person¡¯s own immune system recognize and destroy cancer cells. These drugs have different side effects from those of chemotherapy. Immunotherapy might be used to treat some advanced vaginal cancers.
Immune checkpoint inhibitors
Just as it¡¯s important that immune cells get activated to fight infections and cancer, it¡¯s also important that they turn off when they are no longer needed. Checkpoint proteins on immune cells act as brakes to slow down immune attacks.
Cancer cells sometimes use these checkpoints to keep from being attacked by the immune system.
Drugs that target these checkpoint proteins, called immune checkpoint inhibitors, can help restore the immune response against the cancer cells.
PD-1 inhibitors
PD-1 is a checkpoint protein on immune system cells called T cells. PD-1 normally helps keep T cells from attacking other cells in the body (including some cancer cells). By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.
Pembrolizumab can be used to treat vaginal cancer that has spread to other parts of the body. It is often used along with cisplatin/carboplatin and paclitaxel with or without bevacizumab.
Pembrolizumab can also be used by itself to treat some advanced vaginal cancers. It is typically used after other treatments have been tried or if there are no other good treatment options.
Pembrolizumab often works better treating cancers with many gene changes. It might also be used if the cancer cells are found to have:
- A high level of microsatellite instability, a lot of gene changes in a short, repeated sequence of DNA
- A defect in a mismatch repair gene (dMMR), which causes many gene changes
- A high tumor mutational burden (TMB-H), meaning the cells have many gene changes
- PD-L1, meaning the cancer cells have a high amount of PD-L1 protein on their surface
This drug is given as an intravenous (IV) infusion, typically once every 3 or 6 weeks.
Nivolumab can be used to treat advanced vaginal cancers after other treatments have been tried if the tumor cells are PD-L1 positive.
This drug is given as an IV infusion, typically once every 2 weeks.
Cemiplimab was studied in people with cervical cancer. Because vaginal cancer is relatively uncommon, chemo drugs approved for cervical cancer are commonly used to treat vaginal cancer as well.
It can be given to people with advanced vaginal cancer that came back (recurred) after other treatments whether or not it is PD-L1 positive.
This drug is given as an IV infusion, typically once every 3 weeks.
CTLA-4 inhibitors
CTLA-4 is another checkpoint protein on some T cells. Ipilimumab is a CTLA-4 inhibitor that might be used in combination with nivolumab for advanced vaginal cancer that came back (recurred) after other treatments.
Possible side effects
Side effects of these medicines can include:
- Feeling tired or weak
- Fever
- Cough or shortness of breath
- Nausea
- Skin rash
- Loss of appetite
- Muscle or joint pain
- Constipation or diarrhea
More serious side effects occur less often.
Infusion reactions: These are like allergic reactions and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It¡¯s important to tell your doctor or nurse right away if you have any of these symptoms while getting this drug.
Autoimmune reactions: These occur when immune cells attack normal healthy cells throughout your body. This can lead to problems with your lungs, gut, hormone-making glands like the thyroid, kidneys, or other organs.
It¡¯s very important to report any new side effects to your healthcare team quickly. If serious side effects do occur, treatment might need to be stopped, and you might need other treatment to stop these side effects.
To learn more, see Immune Checkpoint Inhibitors and Their Side Effects.
More information about immunotherapy
To learn more about how drugs that work on the immune system are used to treat cancer, see Cancer Immunotherapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
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- References
Developed by the ÌÇÐÄTV¹ÙÍø Cancer Society medical and editorial content team with medical review and contribution by the ÌÇÐÄTV¹ÙÍø Society of Clinical Oncology (ASCO).
Bejar FG, Oaknin A, Williamson C, et al. Novel Therapies in Gynecologic Cancer. Am Soc Clin Oncol Educ Book. 2022;42:1-17.
Disis ML, Adams SF, Bajpai J, et al. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer. J Immunother Cancer. 2023;11(6):e006624.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Vaginal Cancer Version 2.2026 ¨C December 4, 2025. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/vaginal.pdf on September 8, 2026.
Last Revised: October 23, 2026
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