Safety and Efficacy of Nivolumab and Imiquimod Combination in Vulvar Squamous Cell Carcinoma Patients

Inclusion Criteria: I1. Female patient ≥ 18 years of age on day of signing informed consent. I2. Histologically confirmed primary VSCC, with all of the following characteristics: * At least 1 lesion that can be measured in at least 1 dimension with ≥ 10 mm in largest diameter * Clinically stage FIGO I-III (2021 FIGO staging) * Eligible for primary tumour surgery * Surgical complexity due to either bulky tumors \> 4 cm OR multifocal tumor (defined as the presence of two or more foci of cancer on the vulva), the largest lesion must be ≥ 10 mm and all lesions ≥ 10 mm are designated as "target" lesion(s) for all subsequent tumor evaluations OR any tumor for which a surgical excision would have anatomical or functional consequences deemed significant by the treating surgeon I3. Availability of a representative formalin-fixed paraffin-embedded (FFPE) sample of the primary tumor tissue (biopsy) with an associated pathology report. This tumor sample must meet the following quality/quantity control criteria: ≥30 % of tumor cells and a tumor surface area ≥ 5mm2 I4. Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) ≤ 2 I5. Patients with adequate organ function: * Absolute Neutrophil Count (ANC) ≥ 1 10\^9/L * Platelets ≥ 100 10\^9/L (without transfusion for platelets within 7 days) * Hemoglobin ≥ 9 g/dL * Creatinine clearance according to CKD-EPI ≥ 30 mL/min * Serum total bilirubin ≤ 1.5 x ULN (except for patients with Gilbert disease for whom a total serum bilirub…