Neoadjuvant chemotherapy found safe, efficacious in penile cancer

Neoadjuvant platinum-based chemotherapy with lymphadenectomy demonstrated safety and efficacy in the treatment of patients with locally advanced penile squamous cell carcinoma (PSCC), according to recent data published in the Journal of the National Cancer Institute.¹

The primary and secondary end points were overall survival and progression-free survival.

“Our findings provide compelling evidence for the efficacy and safety of neoadjuvant chemotherapy in treating locally advanced penile squamous cell carcinoma. These results underscore the importance of a multimodal approach in addressing this challenging disease and offer hope for improved patient outcomes,” said study author Philippe E. Spiess, MD, FACS, FRCS, in a news release on the findings.² Spiess is the assistant chief of surgical services and a senior member of the genitourinary oncology department at Moffitt Cancer Center in Tampa, Florida.

Data from the study showed an objective response rate of 57.2% among patients treated with neoadjuvant chemotherapy, with 43.2% (n = 87) or patients demonstrating a partial response and 13.9% (n = 28) demonstrating a complete response. Those who experienced a response had a median overall survival of 73.0 months, compared with 17.0 months among non-responders (P < .01).

In total, 106 patients died during follow-up. Among all patients, the median progression-free survival was 26.0 months (95% CI, 11.7-40.2), and the median overall survival was 37.0 months (95% CI, 23.8-50.1). The lymph node pathologic complete response rate was 24.8%.

“We also found that neoadjuvant platinum-based chemotherapy was well tolerated, with only 17% of patients experiencing grade 3 or higher treatment-related adverse events. Importantly, no treatment-related mortality was observed,” added senior author Jad Chahoud, MD, MPH, in the news release.² Chahoud is an assistant member of the genitourinary oncology department at Moffitt Cancer Center.

In total, the study included 209 patients with locally advanced PSCC with clinical lymph node metastasis who underwent at least 1 dose of neoadjuvant chemotherapy. Of all patients, 201 (97%) completed planned subsequent consolidative lymphadenectomy. In total, 7% of patients presented with stage 2 disease, 48% with stage 3 disease, and 45% with stage 4 disease. The primary and secondary end points were overall survival and progression-free survival, as assessed via the Kaplan-Meier method.

Objective response rates were measured using RECIST v1.1. Treatment-related adverse events were graded per the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

The real-world study was conducted in collaboration with institutes across the United States, Europe, and South America. According to the news release by Moffitt Cancer Center,² the study represents the largest retrospective cohort analysis in PSCC to date.

References

1. Rose KM, Pham R, Zacharias NM, et al. Neoadjuvant platinum-based chemotherapy and lymphadenectomy for penile cancer: An international, multi-Institutional, real-world study. J Natl Cancer Inst. 2024:djae034. doi:10.1093/jnci/djae034

2. Moffitt study finds neoadjuvant chemotherapy significantly improves outcomes for penile squamous cell carcinoma patients. News release. February 16, 2024. Accessed February 21, 2024. https://www.newswise.com/articles/moffitt-study-finds-neoadjuvant-chemotherapy-significantly-improves-outcomes-for-penile-squamous-cell-carcinoma-patients