Skeel Roland T, Huang Jie, Manola Judith, Wilding George, Dreicer Robert, Walker Paul, Muggia Franco, Crawford E David, Dutcher Janice P, Loehrer Patrick J
Medical College of Ohio, Toledo, Ohio, USA.
Cancer Invest. 2003;21(1):41-6. doi: 10.1081/cnv-120016402.
Combined biological therapy with 13-cis-retinoic acid (13-cRA) and interferon alpha-2a (IFN alpha-2a) was reported to be highly effective in squamous cell carcinoma of the cervix and skin. Squamous cell carcinoma of the penis is rare in the United States, accounting for less than 1/2% of all male malignancies. Because of the association of infection with human papillomavirus with both carcinomas of the cervix and penis and their shared squamous cell histology, we carried out a phase II study of 13-cRA and IFN alpha-2a in carcinoma of the penis.
Eighteen ambulatory patients with surgically unresectable, recurrent, and/or metastatic squamous cell carcinoma of the penis were treated with IFN alpha-2a, 3MU/day administered subcutaneously and 13-cRA, 1 mg/kg orally daily for at least eight weeks, unless intolerable toxicity occurred.
One patient was ineligible; one patient withdrew prior to treatment. Among the 16 eligible, treated patients, there was one complete response. Fourteen patients had progressive disease as their only treatment effect. Two patients were unevaluable for tumor response because they had no follow-up tumor measurements. No unexpected treatment-related toxicities were found on study. The only common form of grade 3 toxicity was hypertriglyceridemia found in eight of the 17 patients (47%). No toxicities above grade 3 were observed.
In contrast to its benefit in squamous cell carcinomas of the cervix and skin, the combination of 13-cRA and IFN alpha-2a has low efficacy in advanced carcinoma of the penis.
据报道,13-顺式维甲酸(13-cRA)与干扰素α-2a(IFNα-2a)联合生物疗法对子宫颈和皮肤鳞状细胞癌具有高效性。阴茎鳞状细胞癌在美国较为罕见,占所有男性恶性肿瘤的比例不到0.5%。由于人乳头瘤病毒感染与子宫颈癌和阴茎癌均有关联,且二者均为鳞状细胞组织学类型,我们开展了一项关于13-cRA和IFNα-2a治疗阴茎癌的II期研究。
18例门诊患者患有手术无法切除、复发和/或转移性阴茎鳞状细胞癌,接受IFNα-2a治疗,皮下注射3MU/天,同时口服13-cRA,1mg/kg/天,至少持续8周,除非出现无法耐受的毒性反应。
1例患者不符合入选标准;1例患者在治疗前退出。在16例符合条件并接受治疗的患者中,有1例完全缓解。14例患者的唯一治疗效果是疾病进展。另外2例患者因未进行后续肿瘤测量而无法评估肿瘤反应。研究中未发现意外的治疗相关毒性。唯一常见的3级毒性反应是高甘油三酯血症,17例患者中有8例(47%)出现该症状。未观察到3级以上的毒性反应。
与对子宫颈和皮肤鳞状细胞癌的疗效不同,13-cRA与IFNα-2a联合治疗晚期阴茎癌的疗效较低。