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Research in penile cancer
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help find and treat penile cancer.
The following is a selection of research showing promise for penile cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year. You can find information about ongoing clinical trials in Canada from CanadianCancerTrials.ca and ClinicalTrials.gov. Clinical trials are given an identifier called a national clinical trial (NCT) number. The NCT number links to information about the clinical trial.
Diagnosis and prognosis
A key area of research looks at better ways to diagnose and stage penile cancer. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.
Biomarkers are substances, such as proteins, genes or pieces of genetic material like DNA and RNA, that are found naturally in the body. They can be measured in body fluids like blood and urine or tissue that has been removed from the body. A gene mutation or a change in the normal amount of a biomarker can mean that a person has a certain type of cancer. Researchers are looking at the following biomarkers to see if they can help doctors find new treatments that will benefit a man with penile cancer:
- PPARG and EGFR (Oncotarget, PMID 28122331)
- PD-L1 (Oncoimmunology, PMID 28344882; Human Pathology PMID 27663086)
Gene-based tests find differences between normal genes and genes that are changed (mutated) in cancer cells. Microarray analysis is a type of gene-based test that allows researchers to look at many genes together to see which ones are turned on and which ones are turned off. Analyzing many genes at the same time to see which are turned on and which are turned off is called gene expression profiling. Researchers hope that developing more gene-based tests will help doctors identify the best treatments for certain cancers, including penile cancer. Gene-based tests will also help doctors tailor more treatments to each person’s cancer based on their unique genetic makeup (The Oncologist, PMID 26670666; ASCO, Abstract 4573).
Doppler ultrasound is a type of ultrasound that can show the flow of blood in the body. A recent study compared Doppler ultrasound with magnetic resonance imaging (MRI). Researchers used both tests to see if penile cancer had spread into the spongy tissues of the penis to decide if the penis could be preserved during surgery. Results show that Doppler ultrasound was as effective as MRI in finding cancer that had spread to the spongy tissues. The advantage of using Doppler ultrasound is that it is a less expensive diagnostic test (Urology, PMID 26776562).
Looking at the lymph nodes in the groin is an important part of diagnosis for penile cancer because the number of lymph nodes that cancer has spread to can affect survival. Researchers are using the following imaging tests with sentinel lymph node biopsy to see if they can better identify cancerous lymph nodes:
- FDG PET/CT (BJU International, PMID 26216234)
- SPECT/CT (European Journal of Nuclear Medicine and Molecular Imaging, PMID 28175934)
Find out more about research in diagnosis and prognosis.
Researchers are looking for new ways to improve treatment for penile cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for penile cancer.
The InPACT trial is an international trial with participating sites in Canada. It is investigating what the best order is for chemotherapy, radiation therapy and surgery in the treatment of men who have penile cancer that has spread to the lymph nodes. It isn’t known whether initial treatment with chemotherapy or chemo-radiation prior to having surgery is better than having the surgery alone. (NCT 02305654).
Brachytherapy is a type of radiation therapy that uses implants (needles, catheters, wires or seeds) to deliver radiation directly into or near a tumour. It may be offered to men with early stage penile cancer. A recent meta-analysis compared brachytherapy to surgical amputation of the penis. Results found that a majority of the men were able to avoid surgery to remove the penis when treated with brachytherapy. There was no difference in survival between brachytherapy and surgery. If brachytherapy does not work, surgery is used to treat the cancer (Brachytherapy, PMID 25944394).
Total glans resurfacing is when the surgeon uses skin grafts to repair the glans after surgery to remove cancer. One study looked at using total glans resurfacing after treatment for penile cancer that had not grown into deeper tissues in the penis (localized penile cancer). It found that all of the men were still alive 1 year after surgery and only 1 participant had a local recurrence. A large number of men reported an improved sex life after the surgery. The researchers state that total glans resurfacing should be considered a standard treatment for localized penile cancer (Journal of Urology, PMID 28027867).
Dacomitinib is a drug that targets the epidermal growth factor receptor (EGFR) on cancer cells to stop them from growing and dividing. A small study looked at using dacomitinib with men who had penile cancer that had spread to the lymph nodes or to other organs. It found that dacomitinib was an effective treatment in men who did not have an infection with the human papillomavirus (HPV). More research is needed to find out the role that dacomitinib may have as a treatment for penile cancer (ASCO, Abstract 399).
Panitumumab (Vectibix) is a monoclonal antibody that targets the EGFR on cancer cells to stop them from growing and dividing. A small study looked at panitumumab as a treatment for penile cancer that had spread to other parts of the body and came back after surgery and chemotherapy. Results show that panitumumab slightly improved both progression-free survival and overall survival. More research is needed to find out how panitumumab can best be used to treat penile cancer (Clinical Genitourinary Cancer, PMID 26362073).
Learn more about cancer research
Researchers continue to try to find out more about penile cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage penile cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for penile cancer were first shown to be effective through clinical trials.
A substance that can find and bind to a particular target molecule (antigen) on a cancer cell.
Monoclonal antibodies can interfere with a cell’s function or can be used to carry drugs, toxins or radioactive material directly to a tumour.
The amount of time after treatment that a person lives with a disease (such as cancer) without the disease getting worse.
Researchers may measure progression-free survival in clinical trials to find out how well a treatment works.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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