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Chaux A, Canete-Portillo S. Molecular Pathology and Biomarkers of Penile Squamous Cell Carcinoma: Implications for Classification and Management. Surg Pathol Clin 2025; 18:13-24. [PMID: 39890300 DOI: 10.1016/j.path.2024.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2025]
Abstract
This review explores the current understanding and management of penile squamous cell carcinoma, emphasizing recent advances in molecular pathology and treatment strategies. The article discusses the importance of human papillomavirus status in tumor classification and prognosis, highlighting the 2022 WHO classification. The article underscores the need for a multidisciplinary approach to penile cancer management and identifies areas for future research, including refining molecular classification systems and developing predictive biomarkers. It concludes by emphasizing the rapid evolution of penile cancer management and the potential for more personalized treatment strategies.
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Affiliation(s)
- Alcides Chaux
- Facultad de Medicina, Universidad del Norte, Asunción, Paraguay
| | - Sofia Canete-Portillo
- Pathology Department, University of Alabama at Birmingham, 508 20th Street South, Birmingham, AL 35249-6823, USA.
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Khalid F, Bodla ZH, Gaddameedi SR, Macasaet R, Yagnik K, Niaz Z, Fish PN, Du D, Shah S. Evidence-Based Recommendations on the Use of Immunotherapies and Monoclonal Antibodies in the Treatment of Male Reproductive Cancers. Curr Oncol 2025; 32:108. [PMID: 39996908 PMCID: PMC11854063 DOI: 10.3390/curroncol32020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 11/14/2024] [Accepted: 02/06/2025] [Indexed: 02/26/2025] Open
Abstract
The incidence of male reproductive cancers, including prostate, testicular, and penile cancers, has risen in recent years, raising important health concerns. Prostate cancer is the second leading cause of cancer-related mortality in men, while penile cancer, though rare, typically affects men over 60. Testicular cancer, with a lifetime risk of about 0.4% in men, is most common among adolescents and young adults, decreasing sharply after the age of 40. Traditional treatments include chemotherapy, radiation, surgery, and combinations thereof, but advancements in immunotherapy and monoclonal antibodies are showing promising results, particularly for genitourinary cancers. These therapies, targeting immune checkpoints and tumor-specific antigens, are gaining traction as effective alternatives for resistant cases. This review provides evidence-based recommendations on current and emerging immunotherapy and monoclonal antibody treatments for male reproductive cancers, highlighting future directions to optimize patient outcomes.
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Affiliation(s)
- Farhan Khalid
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Zubair Hassan Bodla
- Department of Internal medicine, Graduate Medical Education, College of Medicine, University of Central Florida, Orlando, FL 32827, USA
| | - Sai Rakshith Gaddameedi
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Raymart Macasaet
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Karan Yagnik
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Zahra Niaz
- Department of Medicine, Al-Aleem Medical College, Lahore 54000, Pakistan
| | - Peter N. Fish
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Doantrang Du
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
| | - Shazia Shah
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA (S.R.G.); (K.Y.)
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de Vries HM, Rafael TS, Gil-Jimenez A, de Feijter JM, Bekers E, van der Laan E, Lopez-Yurda M, Hooijberg E, Broeks A, Peters D, Seignette IM, Pos FJ, Horenblas S, van Rhijn BWG, Jordanova ES, Brouwer OR, Schaake E, van der Heijden MS. Atezolizumab With or Without Radiotherapy for Advanced Squamous Cell Carcinoma of the Penis (The PERICLES Study): A Phase II Trial. J Clin Oncol 2023; 41:4872-4880. [PMID: 37487169 DOI: 10.1200/jco.22.02894] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/23/2023] [Accepted: 06/13/2023] [Indexed: 07/26/2023] Open
Abstract
PURPOSE Patients with advanced penile squamous cell carcinoma have a poor prognosis (21% 2-year overall survival [OS] from diagnosis). We assessed the activity of atezolizumab (anti-PD-L1) in patients with advanced penile cancer, with or without radiotherapy (RT). PATIENTS AND METHODS A single-center, nonrandomized phase II study with two treatment arms was conducted in 32 patients with histologically confirmed advanced penile cancer. All patients received atezolizumab (1,200 mg) once every 3 weeks. Twenty patients, who were expected to benefit from RT for locoregional disease control, received additional irradiation. The primary end point was 1-year progression-free survival (PFS) for the complete cohort and was reached if the actual 1-year PFS was at least 35%. Secondary end points included OS, objective response rate (ORR), and tolerability. Exploratory biomarker analyses were conducted in pretreatment specimens. RESULTS Median follow-up was 29.1 months (IQR, 18.1-33.5). Grade 3-4 adverse events related to atezolizumab or RT were observed in 3/32 (9.4%) and 13/20 (65%) patients, respectively. One-year PFS was 12.5% (95% CI, 5.0 to 31.3), which did not meet the study's primary end point. Median OS was 11.3 months (95% CI, 5.5 to 18.7). In the objective response-evaluable population (n = 30; 93.8%), the ORR was 16.7% (95% CI, 6 to 35), including 2 (6.7%) complete responders and 3 (10%) partial responders. Improved PFS was observed in patients with high-risk human papillomavirus (hrHPV)-positive tumors (P = .003) and those with high infiltration of intratumoral CD3+CD8+ T cells (P = .037). CONCLUSION Although the primary end point of 1-year PFS was not met, durable antitumor activity to atezolizumab was observed in a subset of patients. Biomarkers, such as hrHPV and intratumoral CD3+CD8+ T-cell infiltration, may help to better select responders.
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Affiliation(s)
- Hielke M de Vries
- Department of Internal Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Tynisha S Rafael
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Alberto Gil-Jimenez
- Department of Internal Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Molecular Carcinogenesis, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jeantine M de Feijter
- Department of Internal Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Elise Bekers
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Elsbeth van der Laan
- Department of Internal Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marta Lopez-Yurda
- Department of Biostatistics, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Erik Hooijberg
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Annegien Broeks
- Core Facility Molecular Pathology and Biobanking, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Dennis Peters
- Core Facility Molecular Pathology and Biobanking, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Iris M Seignette
- Department of Pathology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Floris J Pos
- Department of Radiation Therapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Simon Horenblas
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Bas W G van Rhijn
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ekaterina S Jordanova
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Oscar R Brouwer
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Eva Schaake
- Department of Radiation Therapy, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Michiel S van der Heijden
- Department of Internal Medicine, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Molecular Carcinogenesis, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
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Lv C, Wu C, Zhang Y, Li W, Wang X, Liang L. Sintilimab-Induced Diabetic Ketoacidosis in a Patient with Radiation and Multichemorefractory Penile Cancer: A Case Report and Literature Review. Curr Oncol 2022; 29:7987-7993. [PMID: 36354692 PMCID: PMC9688826 DOI: 10.3390/curroncol29110632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Penile squamous cell carcinoma (PSCC) is a rare disease. The treatment options for advanced penile cancer are often limited, and the prognosis remains poor. We reported a 52-year-old male recurrent and metastatic PSCC patient with high PD-L1 expression (90%) and TMB (14.4 muts/Mb). He had undergone penectomy, bilateral inguinal lymph node dissection, and excision of the abdominal wall mass. Despite cisplatin-based concurrent chemoradiotherapy and sequential chemotherapy with docetaxel plus cisplatin then being carried out, the carcinoma still progressed. The patient then obtained progression-free survival with continuous sintilimab, although he experienced the new onset of ICI-induced diabetes after 24 cycles of sintilimab and required sustained insulin treatment. He had negative type 1 diabetes-associated autoantibodies and the susceptible HLA genotype DR3-DQ2 haplotype. This is the first patient with radiation and multichemorefractory PSCC who has obtained the remarkable anti-tumor effect of partial regression exceeding 32 months during continuous sintilimab and anlotinib treatment.
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Affiliation(s)
- Chuan Lv
- Department of Endocrinology, People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, Shenyang 110016, China
| | - Can Wu
- Endoscopy Department, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - Yan Zhang
- Department of Ophthalmology, Shenyang Tenth People’s Hospital, Shenyang 110044, China
| | - Wendong Li
- Radiology Department, People’s Hospital of China Medical University, Shenyang 110016, China
| | - Xuesong Wang
- Department of Urology, People’s Hospital of China Medical University, Shenyang 110016, China
| | - Li Liang
- Department of Endocrinology, People’s Hospital of China Medical University, The People’s Hospital of Liaoning Province, Shenyang 110016, China
- Correspondence:
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