Metastatic Penile Squamous Cell Carcinoma Responsive to Enfortumab Vedotin

Abstract

Penile squamous cell carcinoma is a rare disease with very limited data to guide treatment decisions. In particular, there is minimal evidence for effective therapies in the metastatic setting. Here, we present a case of metastatic penile squamous cell carcinoma with response to the Nectin-4 inhibitor enfortumab-vedotin-ejfv (EV). EV was selected due to the evidence of the high expression of Nectin-4 in squamous cell carcinomas, including penile carcinoma. The patient had both radiographic and symptomatic improvement after two cycles of treatment, despite having been treated with multiple prior lines of traditional chemotherapy. This case provides support for the use of antibody–drug conjugates (ADC), including EV, in this disease with few other options in the advanced setting. Further studies examining Nectin-4 and ADCs in penile squamous cell carcinoma should be completed, as high-quality evidence is needed to guide treatment after initial progression for these patients.

Efficacy and safety of antibody–drug conjugates in the treatment of urothelial cell carcinoma: a systematic review and meta-analysis of prospective clinical trials

“…In addition, for prostate cancers, ADCs are primarily focused on six-transmembrane epithelial antigen of prostate 1 (STEAP1), TROP2, prostate-specific membrane antigen (PSMA), CD46, and B7-H3 as the potential targets ( Rosellini et al, 2021 ). Fahey CC et al reported a case of metastatic penile squamous cell carcinoma responsive to EV ( Fahey et al, 2023 ); this case supports the use of ADCs, including EV, in squamous cell carcinomas, including penile cancers, due to the observed high expression of Nectin-4 ( Fahey et al, 2023 ; Grass et al, 2023 ).…”