CD274 and vulvar carcinoma: PD1/PDL1 negatively regulates the proliferation and function of T lymphocytes, allowing the tumor to remain undetected by the immune system.(16,17) In vulvar SCC, PDL1 expression occurs more frequently in HPV-negative cases.(16) Patients with vulvar carcinomas with high PDL1 expression have a higher risk of disease recurrence and mortality.(18) Blocking the PD1/PDL1 interaction offers an alternative immunotherapeutic strategy, and patients with accentuated inflammatory infiltrate in the tumor appear to respond better to this treatment.(19–22)