Sequential Trials of Methotrexate, Cisplatin and Bleomycin for Penile Cancer

Abstract

Methotrexate, bleomycin or cisplatin was used to treat 21 patients with advanced bidimensionally measurable epidermoid carcinoma of the penis. Patient characteristics were similar in all 3 drug trials. Drug therapy was continued with each agent until the disease progressed. Significant tumor regression was observed in 8 of 13 men (61 per cent) treated with methotrexate, 3 of 12 (25 per cent) treated with cisplatin and 3 of 14 (21 per cent) treated with bleomycin. Responders tended to be younger than nonresponders (median age 48 versus 59 years, respectively, p less than 0.05) and lived a median of 8 versus 2 months, respectively (p equals 0.03). Cross-resistance was not encountered among the 3 drugs. Future trials might investigate combination regimens of all 3 agents.

Is Conservative Organ–Sparing Treatment of Penile Carcinoma Justified?

“…Only limited data exist for use of bleomycin as an initial treatment of localized penile carcinoma [12, 37, 38]. An objective response was obtained in 45% (40 of 90) of patients treated with bleomycin [12, 26, 39, 40, 41, 42, 43]. In our series, bleomycin–based chemotherapy caused reduction of tumor size in 84.8% of cases, with 48.5% CR rate.…”

“…Although primary tumor completely disappeared in almost half of the patients, regional metastases responded purely to the drug therapy and only PR was registered in 3 of 5 cases. Other authors had the same success [39, 45]. …”

Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma

“…Three of the eight patients with adjuvant treatment showed no evidence of disease after a mean (range) of 54 (41-76) months, while four in this group died from disease progression after a mean of 11 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) months, and one died from treatmentrelated toxicity. All five patients with metastatic disease died from disease progression after three had shown temporary signs of regression.…”

Local Treatment ofPenile Squamous Cell Carcinoma

“…Regarding chemotherapy [50,51]. Some authors support the synergic effect of chemotherapy and radiotherapy [52].…”