TY - JOUR
T1 - Neoadjuvant platinum-based chemotherapy and lymphadenectomy for penile cancer
T2 - an international, multi-institutional, real-world study
AU - Rose, Kyle M.
AU - Pham, Rachel
AU - Zacharias, Niki M.
AU - Ionescu, Filip
AU - Paravathaneni, Mahati
AU - Marchetti, Kathryn A.
AU - Sanchez, Darren
AU - Mustasam, Arfa
AU - Sandstrom, Reagan
AU - Vikram, Raghu
AU - Dhillon, Jasreman
AU - Rao, Priya
AU - Schneider, Amy
AU - Pagliaro, Lance
AU - Alifrangis, Constantine
AU - Albersen, Maarten
AU - Roussel, Eduard
AU - Master, Viraj A.
AU - Nazha, Bassel
AU - Hernandez, Cindy
AU - Moses, Kelvin A.
AU - Protzel, Chris
AU - Montgomery, Jeffrey
AU - Angel, Martin
AU - Tobias-Machado, Marcos
AU - Spiess, Philippe E.
AU - Pettaway, Curtis A.
AU - Chahoud, Jad
N1 - Publisher Copyright:
© 2024 Oxford University Press. All rights reserved.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Introduction: This study investigated the efficacy and safety of neoadjuvant chemotherapy for locally advance penile squamous cell carcinoma for which current evidence is lacking. Methods: Included patients had locally advanced penile squamous cell carcinoma with clinical lymph node metastasis treated with at least 1 dose of neoadjuvant chemotherapy prior to planned consolidative lymphadenectomy. Objective response rates were assessed using Response Evaluation Criteria in Solid Tumors v1.1. The primary and secondary outcomes were overall survival and progression-free survival, estimated by the Kaplan–Meier method. Treatment-related adverse events were graded per the Common Terminology Criteria for Adverse Events v5.0. Results: A total of 209 patients received neoadjuvant chemotherapy for locally advanced and clinically node-positive penile squamous cell carcinoma. The study population consisted of 7% of patients with stage II disease, 48% with stage III, and 45% with stage IV. Grade 2 treatment-related adverse events occurred in 35 (17%) patients, and no treatment-related mortality was observed. Of the patients, 201 (97%) completed planned consolidative lymphadenectomy. During follow-up, 106 (52.7%) patients expired, with a median overall survival of 37.0 months (95% confidence interval [CI] ¼ 23.8 to 50.1 months) and median progression-free survival of 26.0 months (95% CI ¼ 11.7 to 40.2 months). Objective response rate was 57.2%, with 87 (43.2%) having partial response and 28 (13.9%) having a complete response. Patients with objective response to neoadjuvant chemotherapy had a longer median overall survival (73.0 vs 17.0 months, P < .01) compared with those who did not. The lymph node pathologic complete response rate was 24.8% in the cohort. Conclusion: Neoadjuvant chemotherapy with lymphadenectomy for locally advanced penile squamous cell carcinoma is well tolerated and active to reduce the disease burden and improve long-term survival outcomes.
AB - Introduction: This study investigated the efficacy and safety of neoadjuvant chemotherapy for locally advance penile squamous cell carcinoma for which current evidence is lacking. Methods: Included patients had locally advanced penile squamous cell carcinoma with clinical lymph node metastasis treated with at least 1 dose of neoadjuvant chemotherapy prior to planned consolidative lymphadenectomy. Objective response rates were assessed using Response Evaluation Criteria in Solid Tumors v1.1. The primary and secondary outcomes were overall survival and progression-free survival, estimated by the Kaplan–Meier method. Treatment-related adverse events were graded per the Common Terminology Criteria for Adverse Events v5.0. Results: A total of 209 patients received neoadjuvant chemotherapy for locally advanced and clinically node-positive penile squamous cell carcinoma. The study population consisted of 7% of patients with stage II disease, 48% with stage III, and 45% with stage IV. Grade 2 treatment-related adverse events occurred in 35 (17%) patients, and no treatment-related mortality was observed. Of the patients, 201 (97%) completed planned consolidative lymphadenectomy. During follow-up, 106 (52.7%) patients expired, with a median overall survival of 37.0 months (95% confidence interval [CI] ¼ 23.8 to 50.1 months) and median progression-free survival of 26.0 months (95% CI ¼ 11.7 to 40.2 months). Objective response rate was 57.2%, with 87 (43.2%) having partial response and 28 (13.9%) having a complete response. Patients with objective response to neoadjuvant chemotherapy had a longer median overall survival (73.0 vs 17.0 months, P < .01) compared with those who did not. The lymph node pathologic complete response rate was 24.8% in the cohort. Conclusion: Neoadjuvant chemotherapy with lymphadenectomy for locally advanced penile squamous cell carcinoma is well tolerated and active to reduce the disease burden and improve long-term survival outcomes.
UR - https://www.scopus.com/pages/publications/85195621514
UR - https://www.scopus.com/pages/publications/85195621514#tab=citedBy
U2 - 10.1093/jnci/djae034
DO - 10.1093/jnci/djae034
M3 - Article
C2 - 38366627
AN - SCOPUS:85195621514
SN - 0027-8874
VL - 116
SP - 966
EP - 973
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 6
ER -