Neoadjuvant Platinum-Based Chemotherapy Effective for Metastatic Penile SCC

The use of neoadjuvant platinum-based chemotherapy (NPAC) was effective for the treatment of metastatic penile squamous cell carcinoma (PSCC), according to data from an international, real-world study presented at ESMO Congress 2022.

Jad Chahoud, MD, MPH, of Moffitt Cancer Center, Tampa, Fla., presented this data from what he said was the largest conglomeration of multi-institutional patients with PSCC treated with systemic chemotherapy.

“Neoadjuvant chemotherapy followed by conservative surgery is supported by the NCCN guidelines and AAU  guidelines for patients with bulky fixed or bilateral inguinal lymph node disease, but the evidence supporting these recommendations are lacking and limited by the small sample size and short follow-up of single-center non-randomized clinical trials,” Chahoud said. “Our study aimed to provide further evidence to support the role of neoadjuvant chemotherapy in locally advanced penile cancer.”

The study included 167 patients with locally advanced disease enrolled from eight tertiary care centers. All had undergone NAPC prior to surgical resection. The majority (82%) received paclitaxel/ifosfamide/cisplatin.

About three-quarters of patients underwent penile-sparing surgical procedures, and the remainder had a radical penectomy. The majority also underwent inguinal lymphadenectomy.

The overall response rate was 58%. Serial imaging after NPAC showed that 22% of patients had progressive disease, 20% had stable disease, 47% had partial response, and 11% had a complete response to treatment.

Median overall survival was around 47 months and median progression-free survival was around 22 months. Overall survival was significantly improved in patients with complete or partial response with median overall survival of 119 months and 56 months, respectively.

Progressive disease was a significant predictor for overall survival included (hazard ratio=2.1; P=.02).

“The study highlights and shows the clinical safety and efficacy of NDAC in a large cohort of locally advanced penile cancer patients with a large follow-up,” Chahoud said.

Reference

ESMO Congress 2022 – 1310MO – Neoadjuvant platinum-based chemotherapy (NAPC) for metastatic penile squamous cell carcinoma (PSCC): An international, multicenter, real-world study