Die aktuelle Situation der Chemotherapie des Peniskarzinoms

Protzel, Chris; Ruppin, S.; Milerski, S.; Klebingat, K.-J.; Hakenberg, Oliver W.

doi:10.1007/s00120-009-2108-z

Cited by 22 publications

(4 citation statements)

References 15 publications

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“…In testicular cancer, the treatment of poor-risk and relapsed metastatic disease, which includes only 10 per cent of incident cases, presents a challenge60. In penile cancer, better prognoses have been revealed in primary tumours and lymph node metastases, but visceral and distant disease remains an incurable problem requiring further study61. Urethral carcinoma, with a different natural history in male and female, is the least frequent of the cancers discussed and suffers from a paucity of Level 1 data62.…”

Section: Management Issues Of Rare Cancersmentioning

confidence: 99%

Rare cancers

Pillai

Jayasree

2017

Indian Journal of Medical Research

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Rare cancers account for about 22 per cent of all cancers diagnosed worldwide, disproportionately affecting some demographic groups, with an occurrence of less than 6 per 100,000 individuals annually. Many rare cancers in adults, adolescents and children are not curable, and patients and care providers have little option to take therapeutic decisions. The epidemiology of rare cancers is a challenging area of study but is inadequately addressed. Despite efforts mainly in some European nations, a few improvements have been observed in the management of rare cancers. Reasons for this obvious stagnation are multifactorial and are mainly inherent to logistical difficulties in carrying out clinical trials in very small patient populations, hesitation of the pharmaceutical industry to spend in small markets and complexity in creating adequate information for the development of cost-effective drugs. Rare cancers also face specific challenges that include late and incorrect diagnosis, lack of clinical expertise and lack of research interest and development of new therapies. The utilization of nationally representative study findings for the patients’ evaluation may possibly offer chances to find out pathogenesis and prevalence, and this will eventually lead to control and prevention. Currently, advancing targeted therapies offer a great opportunity for the better management of rare cancers. Conducting clinical trials with small patient population, innovative clinical trial approach, prevailing controlling obstacles for international cooperation and financial support for research are the present challenges for rare cancers. The International Rare Cancers Initiative functions as a main platform for achieving new international clinical trials in rare tumours. This review delineates the current challenges and issues in the interpretation, management and research scenarios of rare cancers.

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Section: Management Issues Of Rare Cancersmentioning

confidence: 99%

Rare cancers

Pillai

Jayasree

2017

Indian Journal of Medical Research

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“…These patients have been treated with various chemotherapy agents and schedules. [1112131415161718] The heterogeneity in these studies makes it difficult to compare the different protocols. Consequently, there is no single standard regimen for the treatment of metastatic and recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

Palliative chemotherapy in carcinoma penis: Does platinum and taxane combination holds a promise?

et al. 2014

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Aim:To report safety and efficacy of chemotherapy incorporating the combination of paclitaxel and platinum in patients with advanced penile carcinoma.Materials and Methods:Retrospective analysis of patient with advanced penile carcinoma undergoing palliative chemotherapy with paclitaxel and platinum combination. The demographic profile, indication of treatment, chemotherapy details, toxicity and survival outcome were noted. Statistical analysis was done for estimation of progression free survival and overall survival. Factors affecting these outcomes were sought for.Results:Eighteen patients with a median age of 47.5 years (31-68 years) were offered palliative intent chemotherapy over a period of 2.5 years. ECOG performance was 1 in 12 patients (66.7%) and 2 in 6 patients (33.3%). The grade of tumor was poorly differentiated in 8 patients (44.4%), moderately differentiated in 5 (27.8%) and we1l differentiated in 5 patients (27.8%). Twelve patients had previous surgical treatment (66.7%), with 2 of them having received groin radiation in past. The indication for treatment was metastatic disease in 7 patients (38.9%) and locally advanced disease in 11 patients (61.1%). Out of 18 patients 13 received chemotherapy. Paclitaxel and carboplatin combination was given in 10 patients (76.9%) while paclitaxel and cisplatin was received by 3 patients (23.1%). The median numbers of cycles received were 3 (1-6 cycles). Response rate was 30.8%. The median estimated progression free survival (PFS) and overall survival (OS) for patients receiving atleast one cycle of chemotherapy (n = 13) were 96 days and 246 days respectively. Among tested variables the median OS in patients who had received 2 or more cycles was 351 days versus 55 days in those who received less than 2 cycles (P = 0.025). However, after applying Bonferroni correction, the difference was no longer significant. There was no toxicity related death or life threatening complication.Conclusion:Our institutional protocol of platinum-based doublet with paclitaxel is effective, well-tolerated and has the advantage being delivered on an outpatient basis alone. Overall, we believe that paclitaxel-platinum is an effective regimen that needs to be investigated further in larger studies.

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“…[78] Probably, this was the reason that in a nationwide survey from Germany on the use of chemotherapy in carcinoma of the penis, the need for a new combination of chemotherapy was warranted. [9]…”

Section: Discussionmentioning

confidence: 99%

Role of paclitaxel and platinum-based adjuvant chemotherapy in high-risk penile cancer

Noronha¹,

Patil²,

Ostwal³

et al. 2012

Urol Ann

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Aim:To study the efficacy and safety of paclitaxel and platinum doublet chemotherapy in penile cancer patients with high-risk features of local failure.Materials and Methods:Retrospective analysis was done of patients with 19 carcinoma of the penis who were offered adjuvant chemotherapy with paclitaxel and platinum combination. The data regarding the surgical details, high-risk features for which chemotherapy was offered, chemotherapy toxicity details (in accordance with CTCAE vs 3), failure pattern, and survival data were noted. SPSS version 16 was used for statistical analysis. Descriptive and Kaplan–Meier survival analysis was performed.Results:Median age of patients was 48 years. Fifteen patients received paclitaxel in combination with cisplatin and four received paclitaxel with carboplatin in view of their low serum creatinine clearance. The treatment was completed by 12 patients (63.2%). Of 79 planned cycles, 50 were taken. The treatment was well tolerated with grade 3-4 gastrointestinal toxicity was seen in 1 patient, grade 3 neurological toxicity in one and grade 5 neutropenia in one patient. Treatment related death occured in one patient. The median follow-up was 15.33 months and 6 loco-regional relapsed had taken place. The estimated median DFS was 16.2 months and the estimated median OS was not reached. The estimated DFS for treatment completed patients was 23.13 months as against 2.16 months for patients not completing treatment.Conclusion:The platinum and taxane doublet chemotherapy was found to be safe and effective.

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Die aktuelle Situation der Chemotherapie des Peniskarzinoms

Abstract: The current state of the art for chemotherapy of penile carcinoma showed a very large variation in Germany. The response rates were disappointing. A nationwide study with new chemotherapy approaches is urgently needed (information under www.uni-rostock.de/peniskarzinom).

Cited by 22 publications

References 15 publications

Rare cancers

Rare cancers

Palliative chemotherapy in carcinoma penis: Does platinum and taxane combination holds a promise?

Role of paclitaxel and platinum-based adjuvant chemotherapy in high-risk penile cancer

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