Innovative systemic therapies for penile cancer

Abstract

Purpose of reviewThe purpose of this review is to look at recent advancements and treatment options of systemic therapies to treat penile squamous cell carcinoma (PSCC). PSCC is a rare cancer that remains with limited funding for research and systemic therapy development. This review aims to discuss the most recent advancements in systemic treatments and our understanding of PSCC. Recent findingsNeoadjuvant chemotherapy (NAC) and adjuvant therapy remain integral parts of treatment in locally advanced PSCC. New potential drug regimens are being studied to expand on the availability of first-line regimen options. There has been a large development in discoveries of cellular pathways and immune system targets as potential treatment options but these therapies as of today have limited trial evidence and currently have no support to be used in a clinical setting. SummaryPSCC is a rare genitourinary cancer with limited treatment options for patients with advanced disease that is refractory to chemotherapy. Although many new therapies targeting the immune system and cellular pathways are being developed for other studies, clinical and translational research for PSCC are still understudied and underfunded.

An update on treatment of penile cancer

“…Multiple studies have established that PSCC highly expresses EGFR protein via IHC and harbors gene amplifications despite the difficulty of targeting activating EGFR mutations. 94 Necchi et al 95 prospectively evaluated panitumumab (anti-EGFR) in patients with unresectable or metastatic PSCC after at least one line of chemotherapy, 11 patients were treated with a median OS of 9.5 months, and one case of grade 3 cutaneous toxicity and diarrhea each. Data from another second-line salvage trial incorporated anti-EGFR agent cetuximab, these patients were retrospectively reviewed receiving taxane therapy alone or in combination as well as cetuximab alone or in combination, there was an ORR of 27% with trend for improved response rate in the cetuximab including regimens compared to other agents (OR = 5.05, p = 0.077).…”

Therapeutic Approaches to Penile Cancer: Standards of Care and Recent Developments

“…EGFR protein is highly expressed in penile SCC, and represents an area of contemporary research in advanced disease. 64 Anti-EGFR agents such as panitumumab have been investigated in the setting of unresectable and/or metastatic disease, with a median OS of 9.5 months. 65 The efficacy of cetuximab (anti-EGFR) was evaluated retrospectively in patients with advanced disease, comparing the efficacy of cetuximab given alone versus taxane therapy alone versus combination cetuximab and taxane therapy.…”

Recent developments in the diagnosis and management of N1 penile cancer

“…Evaluation of PDL-1 for pSCC as prognostic may be supplanted by its role as an immunotherapy target. Indeed, numerous trials are underway, and data are beginning to emerge that treating highrisk pSCC with PD-1 inhibitors may hold promise [25,26]. Delineating the role of biomarkers both as predictors of nodal disease and therapeutic targets is crucial to the future of pSCC management.…”