707MO - Longitudinal cohort analysis of patients with metastatic penile cancer treated in a large quaternary academic centre

Background

Metastatic penile squamous carcinoma (mSCC) is a very rare disease with poor outcomes despite the use of platinum-based chemotherapy agents. There is limited real-world data on how these patients are managed in clinical practice and their outcomes. To our knowledge this is the largest review of such patients to date.

Methods

A prospective database of over 1200 patients referred to the supra-regional penile multi-disciplinary team (MDT) at St George’s Hospital London was collected from 2006 to 2020. Patients were treated at St George’s Hospital or at other centres with oncology guidance from the St George’s MDT. Metastatic disease was defined as the presence of disease outside the pelvis or those in whom curative therapy for the metastasis was not possible and hence treated with palliative intent. Indication of treatment was to treat symptoms and prolong survival. Clinical benefit rate (CBR), median progression free survival (mPFS) and median overall survival (mOS) were analyzed retrospectively.

Results

101 patients (median age 63, IQR (56-72), 73% ECOG 0/1) were included. 32% (32/101) received adjuvant chemotherapy prior to metastatic recurrence of disease. 59% (59/101) patients received chemotherapy and 42% (42/101) received best supportive care (BSC). 17% (17/101) patients received subsequent second-line systemic therapy and 3% (3/101) patients received third-line systemic therapy.

For first-line systemic-therapy (n=59), there was a 46% (27/59) CBR with 9% (5/59) complete response, 15% (9/59) partial response and 22% (13/59) stable disease. Patients receiving 2nd line subsequent- therapy (n=17) had a 29% (5/17) CBR. mPFS for first- and second-line treatment was 3.2 (95% CI: 2.0-4.5) and 2.2 (95% CI: 1.9-2.4) months respectively. mOS for all patients was 6.2 months (95% CI: 5.1-7.2). mOS for first-line chemotherapy, second-line chemotherapy and BSC patients was 7.2 (95% CI: 5.9-8.5), 4.5 (95% CI: 2.5-6.5) and 2.0 (95% CI: 1.1-2.9) months respectively.

Conclusions

First-line platinum-based chemotherapy is associated with notable response rates in mSCC patients. Subsequent therapy can be beneficial but outcomes remain sub-optimal. Agents with better response rates are needed urgently potentially in combination with platinum-based chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.