The majority of penile carcinoma is squamous cell carcinoma. Although uncommon in
the United States, it represents a larger proportion of cancers in the
underdeveloped world. Invasive squamous cell carcinoma may arise from precursor
lesions or de novo , and has been associated with lack of
circumcision and HPV infection. Early diagnosis is imperative as lymphatic
spread is associated with a poor prognosis. Radical surgical treatment is no
longer the mainstay, and penile sparing treatments now are often used, including
Mohs micrographic surgery. Therapeutic decisions should be made with regard to
the size and location of the tumor, as well as the functional desires of the
patient. It is critical for the dermatologist to be familiar with the
evaluation, grading/staging, and treatment advances of penile squamous cell
carcinoma. Herein, we present a review of the literature regarding penile
squamous cell carcinoma, as well as a case report of invasive squamous cell
carcinoma treated with Mohs micrographic surgery.
Control of the cell cycle through selective pharmacological inhibition of CDK4/6 has proven beneficial in the treatment of breast cancer. Extending this level of control to additional cell cycle CDK isoforms represents an opportunity to expand to additional tumor types and potentially provide benefits to patients that develop tumors resistant to selective CDK4/6 inhibitors. However, broad-spectrum CDK inhibitors have a long history of failure due to safety concerns. In this approach, we describe the use of structure-based drug design and Free−Wilson analysis to optimize a series of CDK2/4/6 inhibitors. Further, we detail the use of molecular dynamics simulations to provide insights into the basis for selectivity against CDK9. Based on overall potency, selectivity, and ADME profile, PF-06873600 (22) was identified as a candidate for the treatment of cancer and advanced to phase 1 clinical trials.
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