Penile Carcinoma: Treatment of Metastatic Disease after Previous Neoadjuvant Chemotherapy and Locoregional Therapy

Abstract

Introduction Metastatic squamous cell carcinoma of the penis is a rare condition in European countries. Neoadjuvant chemotherapy improves local disease control in patients with lymph node metastases and/or inoperable disease. Limited data exist on the efficacy and safety of chemotherapy in the adjuvant setting for patients with metastatic disease after previous neoadjuvant chemotherapy and locoregional therapy. Methods Twelve patients with metastatic penile carcinoma previously treated with neoadjuvant chemotherapy and locoregional therapy were enrolled into the study. Treatment protocol consisted of paclitaxel 175mg/m2 at a 3-week interval. Objective response rate according to Response Evaluation Criteria in Solid Tumors, progression-free survival, overall survival and toxicity were evaluated. Results A partial objective response, a disease stability, and a disease progression were documented in 3, 3 and 6 patients, respectively. Median progression-free survival and median overall survival were 4 and 6 months, respectively. Treatment was well tolerated; only one case of grade 4 toxicity was reported. Conclusions Our initial data suggest that paclitaxel monotherapy is active and well tolerated in patients with metastatic squamous cell penile carcinoma previously treated with neoadjuvant systemic chemotherapy and local therapy. Further studies are therefore needed.