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White J, Mason R, Lawen T, Spooner J, Faria KVM, Rahman F, Ramasamy R. Therapeutic Approaches to Penile Cancer: Standards of Care and Recent Developments. Res Rep Urol 2023; 15:165-174. [PMID: 37288454 PMCID: PMC10243351 DOI: 10.2147/rru.s387228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/24/2023] [Indexed: 06/09/2023] Open
Abstract
Penile cancer is a rare malignancy, most commonly diagnosed in older men, associated with poor outcomes, dramatic decline in quality of life and sexual function. Squamous cell carcinoma is the most common histopathology of penile cancer, accounting for 95% of all cases. Localized, early-stage penile cancer can be effectively managed through penile-sparing techniques in many cases, though advanced stages of penile cancer carry a poor prognosis. Current innovative treatments are exploring the role of targeted therapy, HPV-directed therapy, immune checkpoint inhibitors and adoptive T-cell therapies in treatment and prevention of relapse of penile cancer. Clinical trials are investigating the potential of targeted therapies and immune checkpoint inhibitors in advanced penile cancer. This review examines the current management of penile cancer and highlights future directions in research and treatment.
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Affiliation(s)
- Joshua White
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ross Mason
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Tarek Lawen
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Jesse Spooner
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Kauy V M Faria
- Department of Urology, Institute of Cancer of São Paulo, University of São Paulo School of Medicine, Sao Paulo, Brazil
| | - Farah Rahman
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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Lu Y, Wang Y, Su H, Li H. PD-L1 is associated with the prognosis of penile cancer: A systematic review and meta-analysis. Front Oncol 2022; 12:1013806. [PMID: 36530970 PMCID: PMC9748474 DOI: 10.3389/fonc.2022.1013806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Previous studies have explored the role of PD-L1 in the survival outcomes of penile cancer patients with controversies existed. Thus, the meta-analysis was conducted to report and review the association between PD-L1 and survival in penile cancer patients. METHODS PubMed, Cochrane Library, EMBASE, and Web of Science were all searched, screened, and reviewed by June 1, 2022. Hazard ratio (HR) was used to evaluate the relationship between PD-L1 and survival outcome, and odds ratio (OR) was for tumor features. RESULTS Nine retrospective studies (1,003 patients) were incorporated. The prevalence of PD-L1 in patients with penile cancer was 51.4% (95% CI = 42.1%-60.8%, I 2 = 88.5%). Higher PD-L1 on tumor cells was related to shorter cancer-specific survival (CSS) in patients (HR = 1.578, 95% CI = 1.227-2.029, I 2 = 23.3%), but had no associations with overall survival (OS) (HR = 1.123, 95% CI = 0.511-2.465, I 2 = 0.0%). Subgroup analysis indicated that higher PD-L1 was related to shorter CSS in Caucasus (HR = 1.827, 95% CI = 1.355-2.465, I 2 = 0.0%) only. Furthermore, PD-L1 had associations with tumor stage (pT1 vs. pT2-4, OR = 0.480, 95% CI = 0.346-0.667, P = 0.001) and tumor grade (Well and moderate vs. Poor, OR = 0.377, 95% CI = 0.264-0.538, P < 0.001). PD-L1 positivity was also related to lymph node (LN) status (pN0/NX vs. pN1-3, OR = 0.541, 95% CI = 0.385-0.759, P = 0.001) and HPV status (Positive vs. Negative, OR = 0.510, 95% CI = 0.322-0.810, P = 0.003). A trend toward statistical significance between PD-L1 and histological types was also observed (Usual SCC vs. Others, OR = 1.754, 95% CI = 0.984-3.124, P = 0.070). CONCLUSIONS PD-L1 over-expression was related to worse survival outcomes and several clinicopathological features of penile cancer. PD-L1 expression can be applied to select appropriate treatment strategies for penile malignancies. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343041, identifier CRD42022343041.
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Affiliation(s)
| | | | | | - Hongjun Li
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Chadha J, Chahoud J, Spiess PE. An update on treatment of penile cancer. Ther Adv Med Oncol 2022; 14:17588359221127254. [PMID: 36172172 PMCID: PMC9511530 DOI: 10.1177/17588359221127254] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Penile cancer is a rare malignancy, particularly in industrialized nations. In the United States, rates are approximately less than 1 per 100,000 men per year with just over 2000 new cases per year. However, there is significantly increased prevalence in developing nations, with limited treatment expertise and reduced access to care, further driving an unmet clinical need. The most noteworthy risk factor for penile cancer is the association with human papillomavirus infection, which may be present in up to 50% of all penile carcinomas. In addition to local primary tumor approaches, multimodality treatment strategies are vital to patients with clinical regional nodal disease, locally advanced disease. Presence and degree of lymph node involvement remains the most important prognostic factor and patients may benefit from multiple treatment strategies. Interim analysis data from the first randomized clinical trial is expected to yield results in mid/late 2024–early 2025. These treatment approaches include neoadjuvant chemotherapy, adjuvant therapy, including chemotherapy and radiation. Systemic therapy for distant recurrent or metastatic disease is primarily a platinum-based chemotherapy, however with poor overall response. As poor outcomes remain high, particularly in indigent populations, there remains an unmet need for these patients, particularly for high level randomized trials and novel therapeutics. In this review, we will highlight treatment updates for penile cancer. In addition to standard of care, we will review novel lines of therapies including immunotherapies and targeted therapies as well as sequencing approaches.
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Affiliation(s)
- Juskaran Chadha
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, USA
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Giunchi F, Franceschini T, Fiorentino M. A narrative review of individualized treatments of genitourinary tumors: is the future brighter with molecular evaluations? Transl Androl Urol 2021; 10:1553-1561. [PMID: 33850789 PMCID: PMC8039592 DOI: 10.21037/tau-20-1185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Few molecular prognostic and predictive biomarkers have been identified so far in genitourinary tumors. We started from a literature search to explore the status of the art of molecular pathology tests as diagnostic, prognostic, predictive biomarkers in genitourinary cancers. Next generation sequencing approaches now provide mind-changing information in the fields of kidney cancer diagnosis, predictive oncology of urothelial cancer, understanding the causes of testicular and penile cancer, and the comprehension of the drivers of prostate cancer progression beyond androgen regulation. The classification of kidney cancer will be based soon on molecular changes. The causes of non-HPV related penile cancer are largely unknown. The emerging high incidence of testicular cancer could be explained only on the basis of molecular changes. The response to novel therapeutic agents in prostatic and urothelial cancer will require thorough molecular tumor characterization. The hereditary risk of patients with early onset prostate cancer and their potential treatment with targeted therapy requires germline and somatic genetic assays. The implementation of effective biomarkers for the response to immune check-point inhibitors in genitourinary cancer is based on the assessment of inflammatory expression profiles and the tumor mutational burden. This review deals with the current tests and provides a tentative foresee of the future molecular biomarkers of genitourinary cancer.
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Affiliation(s)
| | - Tania Franceschini
- Metropolitan Department of Pathology, University of Bologna, Bologna, Italy
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Bay JO, Andre T, Bouleuc C, Gandemer V, Magne N, Orbach D, Pellier I, Penel N, Rodrigues M, Thariat J, Thiery-Villemin A, Wisley M, L'Allemain G, Robert J. [What should we remember from 2020?]. Bull Cancer 2021; 108:55-66. [PMID: 33419531 DOI: 10.1016/j.bulcan.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
The editorial committee of the Bulletin du Cancer is proud to comply with his annual analysis of some of the worldwide updates in oncology that emerge in 2020. We know that all new breakthroughs will not be addressed and apologise for not being comprehensive, but we hope that the topics deciphered herein will bring the reader interesting information in his daily practice in gyneco-oncology, uro-oncology, neuro-oncology, digestive oncology, pneumo-oncology, hemato-oncology, pediatric oncology, or in palliative care.
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Affiliation(s)
- Jacques-Olivier Bay
- CHU de Clermont-Ferrand, service de thérapie cellulaire et d'hématologie clinique adulte, UE7453 CHELTER, Inserm CIC-501, site Estaing, 63000 Clermont-Ferrand, France.
| | - Thierry Andre
- AP-HP, hôpital Saint-Antoine, service d'oncologie médicale, 75012 Paris, France
| | - Carole Bouleuc
- Sorbonne université, Paris, France; Institut Curie, département de soins de support, 26, rue d'Ulm, 75005 Paris, France
| | - Virginie Gandemer
- CHU de Rennes, service d'hémato-oncologie pédiatrique, 35000 Rennes, France
| | - Nicolas Magne
- Institut de cancérologie Lucien-Neuwirth, Department of Radiation Oncology, 108 bis, avenue Albert-Raimond, BP 60008, 42270 Saint-Priest-en-Jarez, France; University department of Research and Teaching, Institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France; Laboratory of Molecular and Cellular Radiobiology, UMR CNRS5822/IN2P3, IPNL, PRISME, 69622 Villeurbanne, France
| | - Daniel Orbach
- Institut Curie, centre intégré de soins et de recherche en oncologie de l'enfant, adolescent et jeune adulte (SIREDO), 26, rue d'Ulm, 75005 Paris, France
| | | | - Nicolas Penel
- Lille University, Oscar Lambret Cancer Centre, Medical Oncology Department, 3, rue Frederic-Combemale, 59000 Lille, France
| | - Manuel Rodrigues
- PSL Research University, institut Curie, département d'oncologie médicale, 26, rue d'Ulm, 75005 Paris, France
| | - Juliette Thariat
- Centre François-Baclesse/ARCHADE, département de radiothérapie, 3, avenue General-Harris, 14000 Caen, France; Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534, 14000 Caen, France; Normandie University, UNICAEN, 14000 Caen, France
| | - Antoine Thiery-Villemin
- CHRU Jean-Minjoz, department of medical oncology, 25030 Besançon cedex, France; Université de Franche-Comté, UMR1098, SFR IBCT, 25020 Besançon cedex, France; Inserm, UMR1098, 25020 Besançon cedex, France
| | - Marie Wisley
- Université de Paris, faculté de médecine, 75000 Paris, France; Centre de recherche des Cordeliers, Team « Inflammation, Complement and Cancer », Inserm, 75000 Paris, France; AP-HP Centre, hôpital Cochin, service de pneumologie, unité d'oncologie thoracique, 75000 Paris, France
| | - Gilles L'Allemain
- Institut biologie Valrose, université Côte d'Azur, Inserm U1091, CNRS 7277, 06108 Nice, France
| | - Jacques Robert
- Université de Bordeaux, Inserm U1218, 33000 Bordeaux, France
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Abstract
Penile cancers are rare, the vast majority is represented by squamous cell carcinoma, with HPV virus being found in 30 to 40% of cases. At a locally advanced or metastatic stage, first-line treatment relies on platinum and taxane based polychemotherapy. The prognosis for advanced or metastatic penile cancer remains poor, with overall survival ranging from 13.9 to 17.1 months. After the first line, guidelines recommend various chemotherapy treatments or targeted anti-EGFR therapies whose results as well as the level of evidence are limited. A better understanding of the oncogenic pathways involved in penile cancer and a frequent expression of PD-L1 are the rationale for the elaboration of new strategies. This review article presents the data, guidelines and ongoing studies in locally advanced or metastatic penile cancer.
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