In a recent multi-center study published in the Journal of the National Cancer Institute, researchers examined the effects of neoadjuvant chemotherapy (NAC) on patients suffering from locally advanced penile squamous cell carcinoma (PSCC). Dr. Kyle Rose, urologic oncologist at Ochsner MD Anderson Cancer Center, was the lead author for the publication.
The research included a cohort of 209 patients undergoing NAC, targeting locally advanced and clinically node positive PSCC. The patient group showed a diverse range of disease severity, with a distribution including 7% with stage II, 48% with stage III, and 45% with stage IV PSCC, reflecting the aggressive nature of locally advanced cases. Importantly, the treatments were well-tolerated, with Grade 2 treatment-related adverse events (TrAEs) reported in only 17% of patients, and no treatment-related mortality noted.
A remarkable 97% of the participants were able to complete the planned consolidative lymphadenectomy after chemotherapy, showcasing the procedure's feasibility post-chemotherapy application. Throughout the follow-up period, although 106 patients succumbed to the illness, the median overall survival (OS) reached 37 months, and median progression-free survival (PFS) stood at 26 months.
Notably, the objective response rate (ORR) for the administered NAC was 57.2%. This effectiveness was evident as 43.2% of patients experienced a partial response and 13.9% a complete response. Most striking was the substantial increase in median overall survival for patients who responded to NAC—73 months compared to just 17 months for those who did not, underlining the potential benefits of the treatment.
The lymph-node pathologic complete response rate (ypN0) was found to be 24.8%, indicating a significant reduction in tumor burden for nearly one-fourth of the participants.
Dr. Rose said "Our research provides a hopeful direction for the management of PSCC, which has historically been a challenge to treat effectively. The promising response rates and survival outcomes observed when using NAC followed by surgical intervention suggests a viable treatment approach for those affected by this aggressive form of cancer. Furthermore, the tolerability of this regimen allows us to consider broader applications and gives us a launching pad for future studies to optimize care."
