Systematic Review and Meta-Analysis—Is there a Benefit in Using Neoadjuvant Systemic Chemotherapy for Locally Advanced Penile Squamous Cell Carcinoma?

Azizi, Mounsif; Aydın, Ahmet; Hajiran, Ali; Lai, Andrew; Kumar, Amit; Peyton, Charles C.; Minhas, Suks; Sonpavde, Guru; Chahoud, Jad; Pagliaro, Lance C.; Necchi, Andrea; Spiess, Philippe E.

doi:10.1097/ju.0000000000000746

Cited by 41 publications

(25 citation statements)

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“…Surgery remains the cornerstone of penile cancer treatment for both primary tumors and lymph node metastasis (LNM) with multimodal treatment, in the form of neoadjuvant chemotherapy or adjuvant radiation, reserved for advanced stages [ 15 ]. In regards to systemic therapy, while 50% of the patients achieve an objective response to taxane-ifosphamide-platinum regimens, the majority have demonstrated disappointing 2-year progression-free survival (PFS) and disease-specific survival (DSS) probability of 12% and 28%, respectively [ 16 , 17 , 18 ]. Furthermore, Wang et al reported poor survival outcomes of salvage treatment for disease recurrence after first-line chemotherapy, with a median overall survival of fewer than six months [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy

Ahmed

Falasiri

Hajiran

et al. 2020

JCM

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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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Section: Introductionmentioning

confidence: 99%

The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy

Ahmed

Falasiri

Hajiran

et al. 2020

JCM

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“…Although one systematic review has been published on the efficacy of NAC for locally advanced penile cancer, 45 some differences exist between that study and the current study. First, a comprehensive search of databases was conducted to ensure that all relevant articles were identified.…”

Section: Discussionmentioning

confidence: 85%

Neoadjuvant chemotherapy for patients with locally advanced penile cancer

Yang

et al. 2022

Asian Journal of Andrology

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Neoadjuvant chemotherapy (NAC) has shown promising results in patients with locally advanced penile cancer. However, no consensus exists on its applications for locally advanced penile cancer. Thus, it is unclear which kind of chemotherapy regimen is the best choice. Consequently, a systematic search of PubMed, Web of Science, and EMBASE was performed in March 2021 to assess the efficacy and safety of NAC for the treatment of patients with locally advanced penile cancer. The Newcastle–Ottawa Scale was used to assess the risk of bias in each study. This study synthesized 14 published studies. The study revealed that patients who achieved an objective response to NAC obtained a better survival outcome compared with those who did not achieve an objective response. In addition, the objective response rates (ORRs) and pathological complete response (pCR) rates were 0.57 and 0.11, respectively. The incidence of grade ≥3 toxicity was 0.36. Subgroup analysis found that the ORR and pCR of the taxane–platinum (TP) regimen group performed better than those of the nontaxane–platinum (NTP) regimen group (0.57 vs 0.54 and 0.14 vs 0.07, respectively). Moreover, the TP regimen group had more frequent toxicity than the NTP regimen group (0.41 vs 0.26). However, further studies were warranted to confirm the findings.

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“…Though this avoided the impact of a therapy response from neoadjuvant chemotherapy, bias may have occurred as some advanced patients were not included. However, approximately 16% of patients can achieve a pathological complete response with neoadjuvant chemotherapy ( 27 ). It is difficult to distinguish patients with pathological complete response and absent pelvic metastases.…”

Section: Discussionmentioning

confidence: 99%

Deep Inguinal Lymph Node Metastases Can Predict Pelvic Lymph Node Metastases and Prognosis in Penile Squamous Cell Carcinoma

et al. 2021

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ObjectivesTo evaluate the relationship between deep inguinal lymph node metastasis (ILNM) and pelvic lymph node metastasis (PLNM) and explore the prognostic value of deep ILNM in penile squamous cell carcinoma (PSCC).Materials and MethodsThe records of 189 patients with ILNM treated for PSCC were analysed retrospectively. Logistic regression models were used to test for predictors of PLNM. Cox regression was performed in univariable and multivariable analyses of cancer-specific survival (CSS). CSS was compared using Kaplan-Meier analyses and log rank tests.ResultsPLNM were observed in 53 cases (28.0%). According to logistic regression models, only deep ILNM (OR 9.72, p<0.001) and number (≥3) of metastatic inguinal lymph nodes (ILNs) (OR 2.36, p=0.03) were independent predictors of PLNM. The incidences of PLNM were 18% and 19% with negative deep ILNM and extranodal extension (ENE); and 76% and 42% with positive deep ILNM and ENE, respectively. The accuracy of deep ILNM, ENE, bilateral involvement and number (≥3) of ILNMs for predicting PLNM were 81.0%, 65.6%, 63.5% and 67.2%, respectively. The CSS was significantly different in patients with positive and negative deep ILNM (median 1.7 years vs not reached, p<0.01). Patients who presented with deep ILNM had worse CSS (median 3.8 years vs not reached, p<0.01) in those with negative PLNs.ConclusionsDeep ILNM is the most accurate factor for predicting PLNM in PSCC according to our data. We recommend that patients with deep ILNM should be referred for pelvic lymph node dissection. Involvement of deep ILNs indicates poor prognosis. We propose that patients with metastases of deep ILNs may be staged as pN3.

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Systematic Review and Meta-Analysis—Is there a Benefit in Using Neoadjuvant Systemic Chemotherapy for Locally Advanced Penile Squamous Cell Carcinoma?

Cited by 41 publications

References 0 publications

The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy

The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy

Neoadjuvant chemotherapy for patients with locally advanced penile cancer

Deep Inguinal Lymph Node Metastases Can Predict Pelvic Lymph Node Metastases and Prognosis in Penile Squamous Cell Carcinoma

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