Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
BJU Int. 2014 Jun;113(6):871-7. doi: 10.1111/bju.12450.
To evaluate the safety and efficacy of epidermal growth factor receptor (EGFR)-targeted therapy in patients with advanced penile or scrotal cancer.
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.
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.
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.
评估表皮生长因子受体（EGFR）靶向治疗在晚期阴茎或阴囊癌患者中的安全性和疗效。
我们回顾性分析了 2002 年至 2009 年间在我们的三级癌症中心就诊的阴茎或阴囊鳞状细胞癌患者的病历，包括他们随后的治疗和随访情况。我们收集了 EGFR 靶向治疗和临床结果的详细信息。评估了与治疗相关的疾病进展时间（TTP）、总生存期（OS）、治疗反应和毒性。
共有 24 例患者接受了 EGFR 靶向治疗，包括西妥昔单抗、厄洛替尼和吉非替尼。最常见的治疗方法（67%的患者）是西妥昔单抗联合一种或多种细胞毒性药物。最常见的不良反应是皮疹（71%）。中位（范围）TTP 和 OS 分别为 11.3（1-40）和 29.6（2-205）周。有内脏或骨转移的患者 OS 时间明显短于无转移的患者（24.7 与 49.9 周，P = 0.013）。在单独使用西妥昔单抗或联合顺铂治疗的 17 例患者中，有 4 例部分缓解（23.5%），包括 2 例对化疗耐药的肿瘤患者。
我们的结果表明，西妥昔单抗对转移性阴茎癌具有抗肿瘤活性，并且可能增强基于顺铂的化疗效果。有必要对这些肿瘤患者进行 EGFR 靶向治疗的前瞻性研究。
