Jennifer Wang1, Curtis A Pettaway2, Lance C Pagliaro3. 1. Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: jwang19@mdanderson.org. 2. Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX. 3. Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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.
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: Carlo Buonerba; Giuseppe Di Lorenzo; Gregory Pond; Giacomo Cartenì; Sarah Scagliarini; Antonio Rozzi; Fernando J Quevedo; Tanya Dorff; Lucia Nappi; Gaetano Lanzetta; Lance Pagliaro; Bernhard J Eigl; Gurudatta Naik; Matteo Ferro; Mariano Galdiero; Sabino De Placido; Guru Sonpavde Journal: Front Pharmacol Date: 2016-12-20 Impact factor: 5.810
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Authors: Amarnath Challapalli; Sylvia Pearson; Anita V Mitra; Marc Coe; Alastair Thomson; Tony Elliott; Peter Kirkbride; Lisa Pickering; Hannah Kirk; Emily Foulstone; Heidi Evans; Alicia Bravo; Amit K Bahl Journal: J Int Med Res Date: 2019-09-10 Impact factor: 1.671