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Epidermal growth factor receptor-targeted therapy in locally advanced or metastatic squamous cell carcinoma of the
Bradley C Carthon1, Chaan S Ng, Curtis A Pettaway
1Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Objective:
To evaluate the safety and efficacy of epidermal growth factor receptor (EGFR)-targeted therapy in patients with advanced penile or scrotal cancer.
Patients And Methods:
We retrospectively reviewed the charts of patients with penile or scrotal squamous cell carcinoma who had visited our tertiary cancer centre between 2002 and 2009, including their subsequent treatment and follow-up. We collected details of EGFR-targeted therapy and clinical outcomes. Treatment-associated time-to-disease-progression (TTP), overall survival (OS), responses to therapy and toxicity were evaluated.
Results:
A total of 24 patients had received EGFR-targeted therapies, including cetuximab, erlotinib and gefitinib. The most common treatment given (to 67% of patients) was cetuximab combined with one or more cytotoxic drugs. The most common adverse effect was skin rash (71%). The median (range) TTP and OS were 11.3 (1-40) and 29.6 (2-205) weeks, respectively. The OS time for patients with visceral or bone metastases was significantly shorter than it was for those without (24.7 vs 49.9 weeks, P = 0.013). Among 17 patients treated with cetuximab alone or in combination with cisplatin, there were four partial responses (23.5%) including two patients with apparently chemotherapy-resistant tumours.
Conclusions:
Our results suggest that cetuximab has antitumour activity in metastatic penile cancer, and may enhance the effect of cisplatin-based chemotherapy. Prospective studies of EGFR-targeted therapies in men with these tumours are warranted.
Insights
Epidermal growth factor receptor (EGFR)-targeted therapy, particularly cetuximab, shows antitumour activity in advanced penile cancer. This therapy may also improve outcomes when combined with chemotherapy, warranting further investigation.
Area of Science:
- Oncology
- Medical research
Background:
- Penile and scrotal cancers are rare malignancies.
- Advanced stages often have limited treatment options and poor prognoses.
Purpose of the Study:
- To assess the safety and effectiveness of epidermal growth factor receptor (EGFR)-targeted therapies for advanced penile or scrotal cancer.
Main Methods:
- Retrospective chart review of 24 patients with penile or scrotal squamous cell carcinoma treated between 2002 and 2009.
- Evaluation of EGFR-targeted agents (cetuximab, erlotinib, gefitinib), clinical outcomes, time-to-disease-progression (TTP), overall survival (OS), and toxicity.
Main Results:
- Cetuximab, often with cytotoxic drugs, was the most common EGFR therapy.
- Skin rash was the most frequent adverse event (71%).
- Median TTP was 11.3 weeks, and median OS was 29.6 weeks. Patients with visceral/bone metastases had significantly shorter OS (P=0.013). Four partial responses (23.5%) were observed with cetuximab, including in chemotherapy-resistant cases.
Conclusions:
- Cetuximab demonstrates antitumour activity in metastatic penile cancer.
- It may enhance the efficacy of cisplatin-based chemotherapy.
- Further prospective studies on EGFR-targeted therapies for these cancers are recommended.
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