1
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Hakenberg O, Dräger DL. [Systemic treatment of penile cancer: New concepts? New achievements?]. Aktuelle Urol 2023; 54:304-312. [PMID: 37541237 DOI: 10.1055/a-2104-1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
Systemic chemotherapy has been in use for metastatic penile carcinoma for years, but its success is limited. Its significance is largely associated with its role in multimodal treatment for lymphatic metastasis in the context of radical lymph node surgery. In cases of limited lymph node involvement, the combination of surgical treatment plus cisplatin- and taxane-based triple combinations may be curative. Advances in the understanding of molecular changes in penile cancer and the search for potential therapy targets have led to numerous studies. Although there is evidence of efficacy of immunotherapeutics, no significant therapeutic improvements have been seen in the clinical routine.
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2
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Parza K, Mustasam A, Ionescu F, Paravathaneni M, Sandstrom R, Safa H, Grass GD, Johnstone PA, Eschrich SA, Chadha J, Zacharias N, Pettaway CA, Spiess PE, Chahoud J. The Prognostic Role of Human Papillomavirus and p16 Status in Penile Squamous Cell Carcinoma-A Systematic Review. Cancers (Basel) 2023; 15:3713. [PMID: 37509374 PMCID: PMC10378259 DOI: 10.3390/cancers15143713] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
PSCC is a rare cancer, with approximately half of all cases related to HPV. While HPV and p16 IHC testing have proven their prognostic value for oropharyngeal cancer, this is not yet established for PSCC. The current level of evidence exploring the relation between PSCC and HPV is moderate, so we conducted a systematic review following PRISMA guidelines to evaluate the prognostic role of HPV and p16 IHC in PSCC clinical outcomes. We searched the PubMed, Embase, and Cochrane databases and identified 34 relevant studies that met our inclusion criteria. Of these, 33 were retrospective cohort studies, and one was a cross-sectional study. Nine studies reported that HPV-positive and p16-positive PSCC had better overall survival (OS) and disease-free survival (DFS). This study highlights the need for a meta-analysis to determine the role of routine HPV status or p16 staining testing as part of the initial diagnosis and staging of PSCC patients worldwide.
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Affiliation(s)
- Kevin Parza
- Internal Medicine, USF Health Morsani College of Medicine, Tampa, FL 33601, USA
| | - Arfa Mustasam
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Filip Ionescu
- Internal Medicine, USF Health Morsani College of Medicine, Tampa, FL 33601, USA
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Mahati Paravathaneni
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Reagan Sandstrom
- Graduate Medication Education, USF Health Morsani College of Medicine, Tampa, FL 33602, USA
| | - Houssein Safa
- Hematology Oncology Department, Baylor College of Medicine, Houston, TX 77001, USA
| | - G Daniel Grass
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Peter A Johnstone
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Steven A Eschrich
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Juskaran Chadha
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Niki Zacharias
- Department of Urology, M.D. Anderson Cancer Center, University of Texas, Houston, TX 77001, USA
| | - Curtis A Pettaway
- Department of Urology, M.D. Anderson Cancer Center, University of Texas, Houston, TX 77001, USA
| | - Philippe E Spiess
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Jad Chahoud
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
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3
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Bada M, Crocetto F, Nyirady P, Pagliarulo V, Rapisarda S, Aliberti A, Boccasile S, Ferro M, Barone B, Celia A. Inguinal lymphadenectomy in penile cancer patients: a comparison between open and video endoscopic approach in a multicenter setting. J Basic Clin Physiol Pharmacol 2023; 34:383-389. [PMID: 36933235 DOI: 10.1515/jbcpp-2023-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/25/2023] [Indexed: 03/19/2023]
Abstract
OBJECTIVES To compare differences of operative outcomes, post-operative complications and survival outcomes between open and laparoscopic cases in a multicenter study. METHODS This was a retrospective cohort study performed at three European centers from September 2011 to January 2019. The surgeon decision to perform open inguinal lymphadenectomy (OIL) or video endoscopic inguinal lymphadenectomy (VEIL) was done in each hospital after patient counselling. Inclusion criteria regarded a minimum follow-up of 9 months since the inguinal lymphadenectomy. RESULTS A total of 55 patients with proven squamous cell penile cancer underwent inguinal lymphadenectomy. 26 of them underwent OIL, while 29 patients underwent VEIL. For the OIL and VEIL groups, the mean operative time was 2.5 vs. 3.4 h (p=0.129), respectively. Hospital stays were lower in the VEIL group with 4 vs. 8 days in OIL patients (p=0.053) while number of days requiring drains to remain in situ was 3 vs. 6 days (p=0.024). The VEIL group reported a lower incidence of major complications compared to the OIL group (2 vs. 17%, p=0.0067) while minor complications were comparable in both groups. In a median follow-up period of 60 months, the overall survival was 65.5 and 84.6% in OIL and VEIL groups, respectively (p=0.105). CONCLUSIONS VEIL is comparable to OIL regarding safety, overall survival and post-operative outcomes.
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Affiliation(s)
- Maida Bada
- Department of Urology, San Bassanino Hospital, Bassano del Grappa, Vicenza, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology - Federico II University of Naples, Naples, Italy
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Budapest, Italy
| | - Vincenzo Pagliarulo
- Department of Urology, Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Puglia, Italy
| | - Sebastiano Rapisarda
- Department of Urology, Pederzoli Hospital Private Clinic SpA, Peschiera del Garda, Veneto, Italy
| | - Antonio Aliberti
- Urology, ASL 3 Napoli Castellammare di Stabia, Castellammare di Stabia, Italy
| | - Stefano Boccasile
- Department of Urology, Cima Barcelona Hospital, Barcelona, Catalogna, Spain
| | - Matteo Ferro
- Istituto Europeo di Oncologia, Milano, Lombardia, Italy
| | - Biagio Barone
- Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Napoli, Campania, Italy
| | - Antonio Celia
- Department of Urology, San Bassanino Hospital, Bassano del Grappa, Veneto, Italy
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4
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The Evolving Landscape of Viral, Immune, and Molecular Biomarkers in Penile Cancer. Urol Clin North Am 2023; 50:145-150. [DOI: 10.1016/j.ucl.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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5
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Joshi VB, Chadha J, Chahoud J. Penile cancer: Updates in systemic therapy. Asian J Urol 2022; 9:374-388. [DOI: 10.1016/j.ajur.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/25/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
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6
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Buonerba C, Scafuri L, Costabile F, D’Ambrosio B, Gatani S, Verolino P, Trolio RD, Cosimato V, Verde A, Lorenzo GD. Immune checkpoint inhibitors in penile cancer. Future Sci OA 2021; 7:FSO714. [PMID: 34258024 PMCID: PMC8256326 DOI: 10.2144/fsoa-2021-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 04/14/2021] [Indexed: 12/30/2022] Open
Affiliation(s)
- Carlo Buonerba
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici 80055, Italy
| | - Luca Scafuri
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici 80055, Italy
- Oncology Unit, Hospital ‘Andrea Tortora’, ASL Salerno, Pagani, Italy
| | - Ferdinando Costabile
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici 80055, Italy
- Oncology Unit, Hospital ‘Andrea Tortora’, ASL Salerno, Pagani, Italy
| | - Bruno D’Ambrosio
- Oncology Unit, Hospital ‘Andrea Tortora’, ASL Salerno, Pagani, Italy
| | - Simona Gatani
- Oncology Unit, Hospital ‘Andrea Tortora’, ASL Salerno, Pagani, Italy
| | - Pasquale Verolino
- Multidisciplinary Department of Medical-Surgical & Dental Specialties, Plastic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Rossella Di Trolio
- Unit of Melanoma, Cancer Immunotherapy & Development Therapeutics, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione G. Pascale, Naples, Italy
| | - Vincenzo Cosimato
- Division of Laboratory Medicine, Civil Hospital ‘Maria SS. Addolorata’, ASL Salerno, Eboli, Italy
| | - Antonio Verde
- Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici 80055, Italy
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7
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Raison N, Minhas S. Radiosensitisation of Squamous Cell Carcinoma of the Penis in Men Who Are Positive for Human Papillomavirus Infection. Eur Urol Oncol 2020; 4:811-812. [PMID: 33358392 DOI: 10.1016/j.euo.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Nicholas Raison
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Suks Minhas
- Imperial Andrology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.
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8
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Ahmed ME, Falasiri S, Hajiran A, Chahoud J, Spiess PE. The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy. J Clin Med 2020; 9:E3334. [PMID: 33080912 PMCID: PMC7603091 DOI: 10.3390/jcm9103334] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
Penile cancer is an extremely rare malignancy that accounts for approximately 1% of cancer deaths in the United States every year. While primary penile cancer can be managed surgically, advanced and metastatic forms of the disease require more aggressive management plans with systemic chemotherapy and/or radiotherapy. Despite the meaningful response to systemic treatments, the 2-year progression-free survival and disease-specific survival have shown disappointing results. Therefore, there is a crucial need for alternative treatment options with more favorable outcomes and a lower toxicity profile. There are currently extensive studies of tumor molecular biology and clinical trials with targeted molecular therapies, such as PD-1, PD-L1, and CTLA-4. In this review, we will describe the penile cancer microenvironment, and summarize the rationale for immunotherapy in penile cancer patients.
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Affiliation(s)
| | - Shayan Falasiri
- Department of Urology, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA;
| | - Ali Hajiran
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
| | - Jad Chahoud
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
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9
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Resch I, Abufaraj M, Hübner NA, Shariat SF. An update on systemic therapy for penile cancer. Curr Opin Urol 2020; 30:229-233. [PMID: 31972637 DOI: 10.1097/mou.0000000000000733] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Whereas substantial advances have been made in systemic tumour therapy in the past decade, the prognosis of advanced squamous cell carcinoma (SCC) of the penis remains disproportionally poor. In this review, we aimed to present an update on systemic therapy of penile SCC highlighting the most recent data and future perspectives. RECENT FINDINGS Lymph node metastases play a key role in treating and assessing the prognosis of patients with penile SCC. Data show longer overall survival with the use of adjuvant chemotherapy in patients with pelvic lymph node metastases and recent analyses lead to the development of a nomogramm predicting overall survival in connection with the use of perioperative chemotherapy. There are two pathways in the pathogenesis of penile cancer, including human papilloma virus related and unrelated, leading to many possible novel therapeutic targets. Other targeted therapies have been evaluated, which show promising results with the use of tyrosine kinase inhibitors. SUMMARY Chemotherapy has shown moderate activity in advanced stages of the disease, however, the ideal timing of chemotherapy in patients with lymph node metastases is not entirely clear. Potential targets for future therapies exist, and are already being tested in other malignancies. Owing to the rarity of this condition, a robust evidence is lacking and it is of great importance to pursue further research to unveil several aspects of this disease, particularly in patients with recurrence, lymph node metastases or metastatic disease.
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Affiliation(s)
- Irene Resch
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Mohammad Abufaraj
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.,The National Center for Diabetes, Endocrinology and Genetics, The University of Jordan, Amman, Jordan
| | - Nicolai A Hübner
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.,Department of Urology, Weill Medical College of Cornell University, New York, NY, USA.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,European Association of Urology Research Foundation, Arnheim, Netherlands
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10
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Teh J, O'Connor E, O'Brien J, Lim WM, Taylor M, Heriot A, Ramsay R, Lawrentschuk N. Future directions in advanced penile cancer - mechanisms of carcinogenesis and a search for targeted therapy. Future Oncol 2020; 16:2357-2369. [PMID: 32713198 DOI: 10.2217/fon-2020-0434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Penile squamous cell carcinoma (SCC) is a rare and aggressive urological malignancy. Advanced penile SCC requires multimodal management, including surgery and systemic therapy. Given its rarity, there have been few substantial advances in our understanding of the molecular and genomic drivers of penile SCC, especially for patients with relapsed or advanced disease. In this review, we discuss the molecular and genomic landscape of penile SCC, clinical trials in progress and implications for novel therapeutic targets. Future work should focus on preclinical models to provide a platform for investigation and validation of new molecular pathways for testing of therapeutics.
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Affiliation(s)
- Jiasian Teh
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia.,University of Melbourne, Department of Surgery, Austin Hospital, Melbourne, Victoria 3084, Australia
| | - Ellen O'Connor
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia.,University of Melbourne, Department of Surgery, Austin Hospital, Melbourne, Victoria 3084, Australia
| | - Jonathon O'Brien
- Department of Surgery, University of Melbourne & Royal Melbourne Hospital, Department of Urology, Melbourne, Victoria 3000, Australia
| | - Wei Mou Lim
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia
| | - Michael Taylor
- Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Alexander Heriot
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia
| | - Robert Ramsay
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia.,Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Melbourne, Victoria 3000, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Centre, Melbourne, Victoria 3000, Australia.,Department of Surgery, University of Melbourne & Royal Melbourne Hospital, Department of Urology, Melbourne, Victoria 3000, Australia.,EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Victoria 3121, Australia
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11
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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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12
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Treating Penile Cancer in the Immunotherapy and Targeted Therapy Era. Case Rep Oncol Med 2019; 2019:8349793. [PMID: 31019822 PMCID: PMC6452553 DOI: 10.1155/2019/8349793] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/18/2019] [Indexed: 11/30/2022] Open
Abstract
While localized penile cancers are typically treated surgically and metastatic penile cancers benefit from standard chemotherapy, there have been studies on the horizon demonstrating immunotherapy as a novel approach to metastatic penile cancers that have failed standard chemotherapy. We report a case series of two patients who improved on immunotherapy after progressing with standard chemotherapy regimens. The first case describes a 64-year-old male with a penile mass and significant lymphadenopathy who had surgical resection and adjuvant chemotherapy prior to continued disease progression. He was started on anti-EGFR treatment and improved initially, but he eventually had progression of disease. The second case describes a 79-year-old male with a penile mass who was treated with surgical resection and started on adjuvant chemoradiation, but he developed recurrence and nodal involvement. Therefore, second-line therapy of the PD-L1 inhibitor was started in this patient. There were no available clinical trials for penile cancer patients who progressed beyond the standard surgical therapy and chemotherapy.
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13
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Hakenberg OW, Dräger D, Erbersdobler A. Pathology, Molecular Biology, and Prognosis of Penile Squamous Cell Carcinoma: What Can We Learn from the Specimen? EUROPEAN UROLOGY SUPPLEMENTS 2018; 17:138-145. [DOI: 10.1016/j.eursup.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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14
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Sand FL, Rasmussen CL, Frederiksen MH, Andersen KK, Kjaer SK. Prognostic Significance of HPV and p16 Status in Men Diagnosed with Penile Cancer: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2018; 27:1123-1132. [DOI: 10.1158/1055-9965.epi-18-0322] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/07/2018] [Accepted: 07/02/2018] [Indexed: 11/16/2022] Open
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15
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May M, Brookman-May SD, Ecke TH, Burger M. Die molekulare Charakterisierung des Peniskarzinoms. Urologe A 2018; 57:398-407. [DOI: 10.1007/s00120-018-0596-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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16
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17
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Gu W, Zhu Y, Ye D. Beyond chemotherapy for advanced disease-the role of EGFR and PD-1 inhibitors. Transl Androl Urol 2017; 6:848-854. [PMID: 29184782 PMCID: PMC5673798 DOI: 10.21037/tau.2017.03.92] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Penile squamous cell carcinoma (SCC) is a rare malignancy with limited treatment options when the tumor is unresectable and/or chemorefractory. Triplet systemic chemotherapy regimens including taxane and cisplatin are recommended, but the response duration can be short and the treatment-related toxicity high. Only a small proportion of patients survive 1 year or longer with the current standard treatment paradigm. Beyond chemotherapy, the use of novel targeted agents, either alone or in combination with traditional chemotherapeutic agents, has appeared to have promising efficacy in patients with platinum-refractory penile cancer. The frequent overexpression of PD-L1 in advanced penile SCC indicates the potential efficacy of PD-1 inhibitors. Upcoming clinical trials using the immune check-point inhibitors may provide exciting landscape and change the paradigm for patients in the future.
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Affiliation(s)
- Weijie Gu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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18
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Advances in Understanding of Penile Carcinogenesis: The Search for Actionable Targets. Int J Mol Sci 2017; 18:ijms18081777. [PMID: 28813024 PMCID: PMC5578166 DOI: 10.3390/ijms18081777] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 12/13/2022] Open
Abstract
Penile cancer (PeCa) is a rare malignancy with potentially devastating effects. Squamous cell carcinoma is the most common variant with distinct precancerous lesions before development into invasive disease. Involvement of the inguinal lymph nodes is the most important prognostic factor in PeCa, and once disease is present outside the groin, prognosis is poor. Metastatic PeCa is challenging to treat and often requires multidisciplinary approaches in management. Due to its rarity, molecular understanding of the disease continues to be limited with most studies based on small, single center series. Thus far, it appears PeCa has diverse mechanisms of carcinogenesis affecting similar molecular pathways. In this review, we evaluate the current landscape of the molecular carcinogenesis of PeCa and explore ongoing research on potential actionable targets of therapy. The emergence of anti-epidermal growth factor receptor (EGFR) and other immunotherapeutic strategies may improve outcomes for PeCa patients.
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20
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Buonerba C, Di Lorenzo G, Pond G, Cartenì G, Scagliarini S, Rozzi A, Quevedo FJ, Dorff T, Nappi L, Lanzetta G, Pagliaro L, Eigl BJ, Naik G, Ferro M, Galdiero M, De Placido S, Sonpavde G. Prognostic and Predictive Factors in Patients with Advanced Penile Cancer Receiving Salvage (2nd or Later Line) Systemic Treatment: A Retrospective, Multi-Center Study. Front Pharmacol 2016; 7:487. [PMID: 28066240 PMCID: PMC5168461 DOI: 10.3389/fphar.2016.00487] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/28/2016] [Indexed: 11/15/2022] Open
Abstract
Introduction and objectives: Metastatic penile squamous cell carcinoma (PSCC) is associated with dismal outcomes with median overall survival (OS) of 6–12 months in the first-line and <6 months in the salvage setting. Given the rarity of this disease, randomized trials are difficult. Prognostic risk models may assist in rational drug development by comparing observed outcomes in nonrandomized phase II studies and retrospective data vs. predicted outcomes based on baseline prognostic factors in the context of historically used agents. In this retrospective study, we constructed a prognostic model in the salvage setting of PSCC patients receiving second or later line systemic treatment, and also explored differences in outcomes based on type of treatment. Materials and methods: We performed a chart review to identify patients with locally advanced unresectable or metastatic PSCC who received second or later line systemic treatment in centers from North America and Europe. The primary outcome was OS from initiation of treatment, with secondary outcomes being progression-free survival (PFS) and response rate (RR). OS was estimated using the Kaplan-Meier method. Cox proportional hazards regression was used to identify prognostic factors for outcomes using univariable and multivariable models. Results: Sixty-five patients were eligible. Seventeen of 63 evaluable patients had a response (27.0%, 95% confidence interval [CI] = 16.6–39.7%) and median OS and PFS were 20 (95% CI = 20–21) and 12 (95% CI = 12, 16) weeks, respectively. Visceral metastasis (VM) and hemoglobin (Hb) ≤ 10 gm/dl were consistently significant poor prognostic factors for both OS and PFS, and Hb was also prognostic for response. The 28 patients with neither risk factor had a median OS (95% CI) of 24 (20–40) weeks and 1-year (95% CI) OS of 13.7% (4.4–42.7%), while the 37 patients with 1 or 2 risk factors had median OS (95% CI) of 20 (16–20) weeks and 1-year (95% CI) OS of 6.7% (1.8–24.9%). Cetuximab-including regimens were associated with a trend for improved RR compared to other agents (Odds ratio = 5.05, 95% CI = 0.84–30.37, p = 0.077). Taxanes vs. non-taxane, and combination vs. single agent therapy was not associated with improved outcomes. The study is limited by its modest sample size. Conclusion: This is the first prognostic classification proposed for patients receiving salvage systemic therapy for advanced PSCC. The presence of VM and Hb ≤ 10 gm/dl was associated with poor OS and PFS. Cetuximab appeared to be associated with better RR. This prognostic model may assist in salvage therapy drug development for this orphan disease by improving interpretation of outcomes seen in nonrandomized data.
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Affiliation(s)
- Carlo Buonerba
- Department of Clinical Medicine and Surgery, University Federico II of NaplesNaples, Italy; Istituto Zooprofilattico Sperimentale del MezzogiornoPortici, Italy
| | - Giuseppe Di Lorenzo
- Department of Clinical Medicine and Surgery, University Federico II of Naples Naples, Italy
| | - Gregory Pond
- Department of Oncology, McMaster University Hamilton, ON, Canada
| | - Giacomo Cartenì
- Unità Operativa Sperimentazioni Cliniche Oncologia, Azienda Ospedaliera di Rilievo Nazionale 'Antonio Cardarelli' Naples, Italy
| | - Sarah Scagliarini
- Unità Operativa Sperimentazioni Cliniche Oncologia, Azienda Ospedaliera di Rilievo Nazionale 'Antonio Cardarelli' Naples, Italy
| | - Antonio Rozzi
- Dipartimento di Oncologia, Istituto Neurotraumatologico Italiano Grottaferrata, Italy
| | - Fernando J Quevedo
- Division of Medical Oncology, Department of Oncology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Tanya Dorff
- Norris Comprehensive Cancer Center, University of Southern California Keck School of Medicine Los Angeles, CA, USA
| | - Lucia Nappi
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver Cancer Center, University of British ColumbiaVancouver, BC, Canada; Department of Urologic Sciences, Vancouver Prostate Centre, University of British ColumbiaVancouver, BC, Canada
| | - Gaetano Lanzetta
- Dipartimento di Oncologia, Istituto Neurotraumatologico Italiano Grottaferrata, Italy
| | - Lance Pagliaro
- Division of Medical Oncology, Department of Oncology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Bernhard J Eigl
- Norris Comprehensive Cancer Center, University of Southern California Keck School of Medicine Los Angeles, CA, USA
| | - Gurudatta Naik
- Section of Hematology-Oncology, Department of Medicine, University of Alabama at Birmingham Comprehensive Cancer Center Birmingham, AL, USA
| | - Matteo Ferro
- Department of Clinical Medicine and Surgery, University Federico II of NaplesNaples, Italy; Department of Urology, European Institute of OncologyMilan, Italy
| | | | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University Federico II of Naples Naples, Italy
| | - Guru Sonpavde
- Section of Hematology-Oncology, Department of Medicine, University of Alabama at Birmingham Comprehensive Cancer Center Birmingham, AL, USA
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Gupta S, Kushwaha VS, Verma S, Khan H, Bhatt MLB, Husain N, Negi MPS, Bhosale VV, Ghatak A. Understanding molecular markers in recurrent oral squamous cell carcinoma treated with chemoradiation. Heliyon 2016; 2:e00206. [PMID: 27981249 PMCID: PMC5148783 DOI: 10.1016/j.heliyon.2016.e00206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 11/04/2016] [Accepted: 11/24/2016] [Indexed: 01/02/2023] Open
Abstract
Introduction Oral cancer accounts for approximately 2.1% of all cancers worldwide. In India, oral squamous cell carcinoma (OSCC) is the most common cancer with half a million new cases diagnosed every year. More than 50% of patients eventually develop local recurrence or metastasis usually within the first 2-years following completion of treatment. It is beneficial to analyze the prognostic significance of Cyclin D1, p53 and EGFR which are critical mediators in the pathogenesis of OSCC. The objective of this study was to assess the association of expression of these markers with recurrence and pattern of recurrence in OSCC patients undergoing chemoradiation. Materials and Methods A Total 290 OSCC cases of locally advanced stage (III, IV) oral cancer with World Health Organization (W.H.O.) performance status of grade 0/1 in the year 2009–2012 were enrolled in the study. Treatment response was assessed according to W.H.O. criteria. Cyclin D1, EGFR and p53 expression in tumor tissue was estimated by immunohistochemical (IHC) method and quantified as percentage positive nuclei. Results During the 2-years follow up, 56 (19.3%) patients recurred, out of which, 47 (83.9%) were locoregional and 9 (16.1%) distant sites. On correlating, χ2 test showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of marker expressions (Cyclin D1, EGFR and p53) with recurrence. The strong positive expressions of all three markers showed significant association with early time of recurrence. The multivariate logistic regression analysis showed significant (P < 0.05 or P < 0.01 or P < 0.001) association of recurrence with primary site, differentiation, Cyclin D1 and p53 expressions indicating these as an independent predictors of recurrence in OSCC. The Cyclin D1, EGFR and p53 expressions also showed significant (P < 0.001) poor survivals (OS, DFS and RFS) in patients with positive/strong positive expressions than negative expression suggesting their prognosis in OSCC. Conclusion Our results signifies that tumors over expressing Cyclin D1, EGFR and p53 are resistant to chemoradiation and are associated with increased risk of locoregional recurrence and metastasis in OSCC patients undergoing chemoradiation.
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Affiliation(s)
- Seema Gupta
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vandana Singh Kushwaha
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sandeep Verma
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Huma Khan
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - M L B Bhatt
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, RMLIMS, Lucknow, Uttar Pradesh, India
| | - Mahendra Pal Singh Negi
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Vivek Vidyadhar Bhosale
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
| | - Ashim Ghatak
- Clinical and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, Uttar Pradesh, India
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Montalcini T, Moraca M, Ferro Y, Romeo S, Serra S, Raso MG, Rossi F, Sannita WG, Dolce G, Pujia A. Nutritional parameters predicting pressure ulcers and short-term mortality in patients with minimal conscious state as a result of traumatic and non-traumatic acquired brain injury. J Transl Med 2015; 13:305. [PMID: 26376778 PMCID: PMC4573301 DOI: 10.1186/s12967-015-0660-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/02/2015] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The association between malnutrition and worse outcomes as pressure ulcers and mortality is well established in a variety of setting. Currently none investigation was conducted in patients with long-term consequences of the acquired brain injury in which recovery from brain injury could be influenced by secondary complications. The aim of this study was to investigate the association between various nutritional status parameters (in particular albumin) and pressure ulcers formation and short-term mortality in minimal conscious state patients. METHODS In this prospective, observational study of 5-months duration, a 30 patients sample admitted to a Neurological Institute was considered. All patients underwent a complete medical examination. Anthropometric parameters like mid-arm circumference and mid-arm muscle circumference and nutritional parameters as serum albumin and blood hemoglobin concentration were assessed. RESULTS At univariate and logistic regression analysis, mid-arm circumference (p = 0.04; beta = -0.89), mid-arm muscle circumference (p = 0.050; beta = -1.29), hemoglobin (p = 0.04, beta -1.1) and albumin (p = 0.04, beta -7.91) were inversely associated with pressure ulcers. The area under the ROC curve for albumin to predict sores was 0.76 (p = 0.02) and mortality was 0.83 (p = 0.03). Patient with lower albumin had significantly higher short-term mortality than those with higher serum albumin (p = 0.03; χ(2) test = 6.47). CONCLUSION Albumin, haemoglobin and mid-arm circumference are inversely associated with pressure ulcers. Albumin is a prognostic index in MCS patients. Since albumin and haemoglobin could be affected by a variety of factors, this association suggests to optimize nutrition and investigate on other mechanism leading to mortality and pressure ulcers.
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Affiliation(s)
- Tiziana Montalcini
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
| | - Marta Moraca
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
| | - Yvelise Ferro
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
| | - Stefano Romeo
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
- Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascolar and Metabolic Research, University of Gothenburg, Gothenburg, Sweden.
| | | | | | | | | | | | - Arturo Pujia
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Viale S. Venuta, 88100, Catanzaro, Italy.
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Lack of P16
ink4a
Over Expression in Penile Squamous Cell Carcinoma is Associated with Recurrence after Lymph Node Dissection. J Urol 2015; 193:519-25. [DOI: 10.1016/j.juro.2014.08.120] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/22/2022]
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Wang JY, Zhu Y, Tang SX, Zhang HL, Qin XJ, Zhang SL, Dai B, Ye DW. Prognostic significance of the degree of extranodal extension in patients with penile carcinoma. Asian J Androl 2014; 16:437-41. [PMID: 24480925 PMCID: PMC4023374 DOI: 10.4103/1008-682x.122862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study sought to assess the prognostic significance of the degree of extranodal extension (ENE) and several other risk factors in pathological ENE penile carcinoma. We analyzed prospectively collected data on a consecutive series of 31 chemotherapy-naive patients with proven ENE who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was then performed. We studied the extent of ENE utilizing a novel grading system and correlated patient grades with their outcome measures. ENE was graded as 1 - if the capsule of the lymph node (LN) was ruptured less than one-third of its circumference or 2 - if the capsule was disrupted more than one-third of its circumference or the entire LN was disrupted. We estimated overall survival (OS) using the Kaplan-Meier method. Multivariate analysis was performed according to the Cox proportional hazards model using factors that were identified as statistically significant in univariate analysis. The incidence rate of ENE was 51.8% in patients with pathological node-positive carcinoma of the penis. The median OS and 5-year survival were 18 months (95% confidence interval (CI), 14.4-21.6) and 23%, respectively. Prognostic variables on univariate analysis were ENE grade 2, ≥ 3 LNs with ENE, maximal LN ≥ 35 mm, ≥ 5 positive LNs and pelvic LN involvement. On multivariate analysis, only ENE grade 2 remained associated with decreased OS (hazard ratio (HR): 6.50). In conclusion, patients with ENE have a poor outcome, and ENE grade 2 is an independent predictive factor of poor OS in patients with pathological ENE penile carcinoma.
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Affiliation(s)
| | | | | | | | | | | | | | - Ding-Wei Ye
- Department of Oncology, Shanghai Medical College, Fudan University; Department of Urology, Fudan University Cancer Hospital, Shanghai, China
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Di Lorenzo G, Buonerba C, Ferro M, Calderoni G, Bozza G, Federico P, Tedesco B, Ruggieri V, Aieta M. The epidermal growth factor receptors as biological targets in penile cancer. Expert Opin Biol Ther 2014; 15:473-6. [DOI: 10.1517/14712598.2015.993377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Wang X, Li S. Protein mislocalization: mechanisms, functions and clinical applications in cancer. BIOCHIMICA ET BIOPHYSICA ACTA 2014; 1846:13-25. [PMID: 24709009 PMCID: PMC4141035 DOI: 10.1016/j.bbcan.2014.03.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 02/20/2014] [Accepted: 03/27/2014] [Indexed: 12/21/2022]
Abstract
The changes from normal cells to cancer cells are primarily regulated by genome instability, which foster hallmark functions of cancer through multiple mechanisms including protein mislocalization. Mislocalization of these proteins, including oncoproteins, tumor suppressors, and other cancer-related proteins, can interfere with normal cellular function and cooperatively drive tumor development and metastasis. This review describes the cancer-related effects of protein subcellular mislocalization, the related mislocalization mechanisms, and the potential application of this knowledge to cancer diagnosis, prognosis, and therapy.
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Affiliation(s)
- Xiaohong Wang
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Shulin Li
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
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Pond GR, Di Lorenzo G, Necchi A, Eigl BJ, Kolinsky MP, Chacko RT, Dorff TB, Harshman LC, Milowsky MI, Lee RJ, Galsky MD, Federico P, Bolger G, DeShazo M, Mehta A, Goyal J, Sonpavde G. Prognostic risk stratification derived from individual patient level data for men with advanced penile squamous cell carcinoma receiving first-line systemic therapy. Urol Oncol 2013; 32:501-8. [PMID: 24332646 DOI: 10.1016/j.urolonc.2013.10.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/20/2013] [Accepted: 10/08/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prognostic factors in men with penile squamous cell carcinoma (PSCC) receiving systemic therapy are unknown. A prognostic classification system in this disease may facilitate interpretation of outcomes and guide rational drug development. We performed a retrospective analysis to identify prognostic factors in men with PSCC receiving first-line systemic therapy for advanced disease. PATIENTS AND METHODS Individual patient level data were obtained from 13 institutions to study prognostic factors in the context of first-line systemic therapy for advanced PSCC. Cox proportional hazards regression analysis was conducted to examine the prognostic effect of these candidate factors on progression-free survival (PFS) and overall survival (OS): age, stage, hemoglobin, neutrophil count, lymphocyte count, albumin, site of metastasis (visceral or nonvisceral), smoking, circumcision, regimen, ECOG performance status (PS), lymphovascular invasion, precancerous lesion, and surgery following chemotherapy. The effect of different treatments was then evaluated adjusting for factors in the prognostic model. RESULTS The study included 140 eligible men. Mean age across all men was 57.0 years. Among them, 8.6%, 21.4%, and 70.0% of patients had stage 2, 3, and 4 diseases, respectively; 40.7% had ECOG PS ≥ 1, 47.4% had visceral metastases, and 73.6% received cisplatin-based chemotherapy. The multivariate model of poor prognostic factors included visceral metastases (P<0.001) and ECOG PS ≥ 1 (P<0.001) for both PFS and OS. A risk stratification model constructed with 0, 1, and both poor prognostic factors was internally validated and demonstrated moderate discriminatory ability (c-statistic of 0.657 and 0.677 for OS and PFS, respectively). The median OS for the entire population was 9 months. Median OS was not reached, 8, and 7 months for those with 0, 1, and both risk factors, respectively. Cisplatin-based regimens were associated with better OS (P = 0.017) but not PFS (P = 0.37) compared with noncisplatin-based regimens after adjusting for the 2 prognostic factors. CONCLUSIONS In men with advanced PSCC receiving first-line systemic therapy, visceral metastases and ECOG PS ≥ 1 were poor prognostic factors. A prognostic model including these factors exhibited moderate discriminatory ability for outcomes and warrants external validation. Patients receiving cisplatin-based regimens exhibited better outcomes compared with noncisplatin-based regimens after adjusting for prognostic factors.
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Affiliation(s)
| | | | - Andrea Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | | | - Raju T Chacko
- Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | | | - Richard J Lee
- Masachussetts General Hospital Cancer Center, Boston, MA
| | | | | | - Graeme Bolger
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL
| | - Mollie DeShazo
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL
| | - Amitkumar Mehta
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL
| | - Jatinder Goyal
- Department of Medicine, UAB Medical Center, Birmingham, AL
| | - Guru Sonpavde
- University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL.
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Protzel C, Seitz A, Hakenberg O, Retz M. Neoadjuvante, adjuvante und palliative Chemotherapie des Peniskarzinoms. Urologe A 2013; 52:1556-60, 1562-3. [DOI: 10.1007/s00120-013-3252-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Li D, Han Z, Liu J, Zhang X, Ren J, Yan L, Liu H, Xu Z. Upregulation of nucleus HDGF predicts poor prognostic outcome in patients with penile squamous cell carcinoma bypass VEGF-A and Ki-67. Med Oncol 2013; 30:702. [PMID: 23999841 DOI: 10.1007/s12032-013-0702-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Accepted: 08/20/2013] [Indexed: 01/27/2023]
Abstract
Hepatoma-derived growth factor (HDGF) has been verified to serve as a credible prognostic marker for several types of cancers, but its role in urologic carcinomas remains undetermined. In this study, we analyzed the significance of HDGF, as well as its relative factors such as vascular endothelial growth factor-A (VEGF-A) and Ki-67, in penile squamous cell carcinoma (PSCC). Formalin-fixed paraffin-embedded PSCC samples from 54 patients receiving surgery at Qilu Hospital of Shandong University were included in the retrospective study. The expressions of HDGF, VEGF-A, and Ki-67 were detected by immunohistochemistry of a non-biotin polymerized horseradish peroxidase method. The relationships between the expressions of HDGF and VEGF-A, Ki-67 were assessed. Moreover, their correlations with clinical pathologic characteristics and disease prognosis were, respectively, evaluated. HDGF, VEGF-A, and Ki-67 were positively expressed in 28 (51.9%), 29 (53.7%), and 26 (48.1%) patients, respectively. The expressions of VEGF-A and Ki-67 were closely correlated with PSCC type (P < 0.05). A statistically significant relationship between the expressions of HDGF and VEGF-A in PSCC was observed (P = 0.03). Patients with symptom interval of more than 6 months had a significantly poorer survival rate than those with symptom interval less than 6 months (43.3 vs. 70.8%, P = 0.043). Patients with positive HDGF expression also showed a significantly poorer survival rate than those with negative HDGF expression (39.3 vs. 73.1%, P = 0.013). Logistic regression demonstrated that the expression level of HDGF was an independent predictor for the prognosis of postoperative patients. The expression of HDGF significantly correlated with VEGF-A, but not Ki-67 expression. Overexpression of HDGF, rather than VEGF-A or Ki-67, was confirmed to be an independent prognosticator of poor outcome for PSCC patients.
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Affiliation(s)
- Dawei Li
- Department of Urology, Qilu Hospital of Shandong University, Jinan, 250012, People's Republic of China,
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