Treatment for Metastatic Penile Cancer After First-line Chemotherapy Failure: Analysis of Response and Survival Outcomes.

Abstract

OBJECTIVE:

To retrospectively estimate the efficacy of various treatments used in men with metastatic penile cancer that progresses after first-line chemotherapy.

METHODS:

Patients were from a 30-patient cohort with stage TxN2-3M0 penile squamous cell carcinoma treated with neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy before planned lymphadenectomy. Nineteen patients (63.3%) had tumor progression or recurrence, and we evaluated the response to subsequent treatment and survival.

RESULTS:

Seventeen had received ≥ 1 salvage therapies; their median survival from first treatment failure was 5.7 months (range, 1.4-30.3 months). Four patients underwent salvage surgery, all of whom experienced further disease progression within 2 months. Four patients received chemoradiotherapy, 1 with stable disease for 13.5 months and 3 with no apparent benefit. Two of 5 evaluable patients (40%) who had received bleomycin, methotrexate, and cisplatin had objective responses (1 complete, 1 partial) but 1 developed fatal pneumonitis. There were no other documented responses to systemic therapy. Median overall survival was 5.6 months for patients who had received a second cisplatin-based treatment at any time and 4.3 months for those who had not (P = .4).

CONCLUSION:

Patients whose metastatic penile carcinoma progresses through or recurs after front-line cisplatin-based chemotherapy experience poor responses to the described salvage treatments, with a median overall survival time of <6 months. Emphasis should be placed on clinical trials for development of effective therapy in this setting.

• Authors: Jennifer Wang, Curtis A Pettaway, Lance C Pagliaro
• Journal: Urology (Urology) Vol. 85 Issue 5 Pg. 1104-1110 (May 2015) ISSN: 1527-9995 [Electronic] United States
• PMID: 25819619 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2015. Published by Elsevier Inc.

Chemical References

• Antineoplastic Agents

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Squamous Cell (mortality, secondary, therapy)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Penile Neoplasms (drug therapy, mortality, pathology, therapy)
• Retrospective Studies
• Salvage Therapy
• Survival Rate
• Treatment Failure
• Treatment Outcome
• Young Adult