PURPOSE
Survivors of penile squamous cell carcinoma (SCC) may be at increased risk of second primary cancers (SPCs), but population-based data in the United States are limited. We evaluated SPC risk among pSCC survivors using the Surveillance, Epidemiology, and End Results (SEER) database.
METHODS
We conducted a population-based retrospective cohort study using SEER (2000-2022). Standardized incidence ratios (SIRs) and excess absolute risks (EARs) were used to compare SPC risk with the general population. Fine-Gray competing-risk regression was performed to identify factors associated with SPC development.
RESULTS
Among 5,378 patients with penile SCC, 599 (11.1%) developed at least 1 SPC. Overall SPC risk was significantly elevated compared with the general population (SIR 1.17; 95% CI 1.09-1.27). Higher relative risks were observed among patients younger than 60 years (SIR 1.48), Black individuals (SIR 1.58), and those with basaloid SCC (SIR 2.12). SPC risk was greatest within the first year after diagnosis (SIR 1.78) and remained elevated within the first 5 years. The highest site-specific risk was observed for cancers of the anus, anal canal, and anorectum (SIR 5.00). In competing-risk analyses, Black race, and basaloid histology were independently associated with increased SPC risk, while advanced stage and absence of surgery were associated with lower observed incidence, likely reflecting competing mortality.
CONCLUSIONS
Survivors of penile SCC have a significantly increased risk of SPCs, particularly HPV-related malignancies. These findings provide important insight into the timing and distribution of SPC risk following penile SCC and may help inform future survivorship research and clinical awareness of SPC risk in this population.
H. Tran, Frank Z. Jing, D. L. Van et al.· Urologic oncology· 0 citations
Aim: Despite advances with immune checkpoint inhibitor (ICI)-based regimens in the past decade, patients with metastatic urothelial cancer (mUC) face a poor prognosis with few approved options. Platinum-based chemotherapy with paclitaxel and carboplatin (TC) +/– ICI may be a feasible choice. Methods: We generated an IRB-approved, HIPAA-compliant retrospective database of patients at Mayo Clinic Cancer Center with mUC who started TC +/– ICI after disease progression on ICI from January 2018 through December 2024. Baseline demographics, clinicopathologic features, and treatment outcomes were extracted from the electronic health record. Kaplan-Meier method was used to calculate median duration of response (DOR), progression-free survival (PFS) and overall survival (OS). Results: There were 32 patients who fit inclusion criteria, including 31 patients who had disease progression on ICI in the metastatic setting and 1 patient who developed metastatic disease on adjuvant nivolumab. Patients received a median of 4 cycles (range 1–14) of TC over median 12 weeks (range 3–53). Overall, 81% of patients received TC concurrently with an ICI, and 28% continued maintenance ICI after TC discontinuation (at the treating oncologist’s discretion due to adequate response or toxicity). The best objective response rate was 41% and disease control rate was 75%, with median DOR of 4.8 months (IQR 2.7–10.4), median PFS of 4.6 months (IQR 3.3–10.2), and median OS of 9.4 months (IQR 6.3–15.9). Some patients in this series had very durable responses with PFS > 12 months and OS > 24 months. TC +/– ICI was overall well tolerated with expected type and severity of adverse events. Conclusions: Strategies to overcome ICI resistance are needed, and TC +/– ICI after disease progression on an ICI shows promising tolerability and efficacy in this setting for patients with mUC. Our series was notable for some patients having a durable response. Validation in larger cohorts is warranted.
Albert Jang, Miguel Muniz, Megan T. Spychalla et al.· Exploration of Targeted Anti...· 0 citations
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