Difference between revisions of "Penile cancer"
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+ | =Adjuvant chemotherapy= | ||
+ | ==TIP== | ||
+ | No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "it is reasonable to give [[#TIP|4 courses of TIP]] in the adjuvant setting if it was not given preoperatively and the pathology shows high-risk features." (see neoadjuvant chemotherapy section) | ||
=Neoadjuvant chemotherapy= | =Neoadjuvant chemotherapy= | ||
Line 10: | Line 14: | ||
TIP: '''<u>T</u>'''axol, '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol | TIP: '''<u>T</u>'''axol, '''<u>I</u>'''fosfamide, '''<u>P</u>'''latinol | ||
− | ===Regimen, Pagliaro et al. 2010=== | + | ===Regimen, Pagliaro, et al. 2010=== |
Level of Evidence: | Level of Evidence: | ||
<span | <span | ||
Line 43: | Line 47: | ||
=Metastatic or unresectable disease= | =Metastatic or unresectable disease= | ||
− | ==Cisplatin, | + | ==Cisplatin & Fluorouracil== |
− | ===Regimen, | + | ===Regimen, Shammas, et al. 1992=== |
+ | Level of Evidence: | ||
+ | <span | ||
+ | style="background:#ff0000; | ||
+ | padding:3px 6px 3px 6px; | ||
+ | border-color:black; | ||
+ | border-width:2px; | ||
+ | border-style:solid;">8 patients reported, 2 with partial response</span> | ||
+ | |||
+ | *[[Cisplatin (Platinol)]] 100 mg/m2 IV once once on day 1 | ||
+ | *[[Fluorouracil (5-FU)]] 1000 mg/m2/day IV continuous infusion on days 1 to 5 | ||
+ | |||
+ | ===References=== | ||
+ | # Shammas FV, Ous S, Fossa SD. Cisplatin and 5-fluorouracil in advanced cancer of the penis. J Urol. 1992 Mar;147(3):630-2. '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/1538445 PubMed] | ||
+ | |||
+ | ==Cisplatin & Irinotecan== | ||
+ | ===Regimen, Theodore, et al. 2008 (EORTC 30992)=== | ||
Level of Evidence: | Level of Evidence: | ||
<span | <span | ||
Line 53: | Line 73: | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
− | *[[Cisplatin (Platinol)]] | + | *[[Cisplatin (Platinol)]] 80 mg/m2 IV over 1 to 3 hours once on day 1, given second |
− | *[[ | + | *[[Irinotecan (Camptosar)]] 60 mg/m2 IV over 30 minutes once per day on days 1, 8, 15, given first |
− | |||
− | |||
− | ''' | + | '''28-day cycles, with up to 4 cycles before surgery in the neoadjuvant setting for T3 or N1 to N2; up to 8 cycles for patients with T4, N3, or M+ distant metastatic disease''' |
Supportive medications: | Supportive medications: | ||
− | * | + | *Adequate hydration with cisplatin, per guidelines at each investigator's site |
− | * | + | *Antiemetic medication per routine local practice. |
+ | *"Systematic premedication with atropine as of the first cycle of treatment was at the investigator's discretion but was not recommended." | ||
===References=== | ===References=== | ||
− | # | + | # Theodore C, Skoneczna I, Bodrogi I, Leahy M, Kerst JM, Collette L, Ven K, Marréaud S, Oliver RD; EORTC Genito-Urinary Tract Cancer Group. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol. 2008 Jul;19(7):1304-7. [http://annonc.oxfordjournals.org/content/19/7/1304.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18417462 PubMed] |
+ | |||
+ | ==Cisplatin, Methotrexate, Bleomycin== | ||
+ | ===Regimen, Haas, et al. 1999 (SWOG 8520)=== | ||
+ | ''The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."'' | ||
− | |||
− | |||
Level of Evidence: | Level of Evidence: | ||
<span | <span | ||
Line 77: | Line 98: | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
− | *[[ | + | *[[Cisplatin (Platinol)]] 75 mg/m2 at a concentration of 1 mg/mL normal saline IV given at a rate of 1 mg/min once on day 1 |
− | *[[ | + | *[[Methotrexate (MTX)]] 25 mg/m2 IV bolus once per day on days 1 & 8 |
− | ** | + | *[[Bleomycin (Blenoxane)]] 10 units/m2 IV bolus once per day on days 1 & 8 |
+ | **Chemotherapy with bleomycin was discontinued when a total cumulative dose of 200 units/m2 was reached | ||
− | ''' | + | '''21-day cycles, given until disease progression; patients who achieved complete remission discontinued therapy after 6 cycles''' |
Supportive medications: | Supportive medications: | ||
− | * | + | *Normal saline IV at 250 mL/hour, starting 1 hour before cisplatin and continued at least 6 hours after cisplatin. |
− | * | + | *Furosemide (Lasix) 40 mg IV once prior to cisplatin |
===References=== | ===References=== | ||
− | # | + | # Haas GP, Blumenstein BA, Gagliano RG, Russell CA, Rivkin SE, Culkin DJ, Wolf M, Crawford ED. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999 Jun;161(6):1823-5. [http://www.sciencedirect.com/science/article/pii/S0022534705688155 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/10332445 PubMed] |
==Paclitaxel (Taxol)== | ==Paclitaxel (Taxol)== | ||
− | ===Regimen, Di Lorenzo et al. 2011=== | + | ===Regimen, Di Lorenzo, et al. 2011=== |
Level of Evidence: | Level of Evidence: | ||
<span | <span | ||
Line 100: | Line 122: | ||
border-style:solid;">Phase II</span> | border-style:solid;">Phase II</span> | ||
− | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV | + | *[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1 |
'''21-day cycles, administered until disease progression or unacceptable toxicity''' | '''21-day cycles, administered until disease progression or unacceptable toxicity''' | ||
Supportive medications: | Supportive medications: | ||
− | * | + | *[[Filgrastim (Neupogen)|G-CSF]] could be used in later cycles if the patient developed febrile neutropenia during treatment |
− | *[[Dexamethasone (Decadron)]] 8 mg PO | + | *[[Dexamethasone (Decadron)]] 8 mg PO given three times, at 12 hours before, immediately before, and 12 hours after paclitaxel |
===References=== | ===References=== | ||
# Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011 Dec;60(6):1280-4. [http://www.sciencedirect.com/science/article/pii/S0302283811008967 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21871710 PubMed] | # Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011 Dec;60(6):1280-4. [http://www.sciencedirect.com/science/article/pii/S0302283811008967 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21871710 PubMed] | ||
+ | |||
+ | ==TIP== | ||
+ | No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "[[#TIP|TIP]] is a reasonable first-line treatment for patients with metastatic penile cancer." (see neoadjuvant chemotherapy section) | ||
+ | |||
+ | ==TPF== | ||
+ | TPF: '''<u>T</u>'''axol, '''<u>P</u>'''latinol, '''<u>F</u>'''luorouracil | ||
+ | |||
+ | ===Regimen, Pizzocaro, et al. 2009=== | ||
+ | Level of Evidence: | ||
+ | <span | ||
+ | style="background:#ff0000; | ||
+ | padding:3px 6px 3px 6px; | ||
+ | border-color:black; | ||
+ | border-width:2px; | ||
+ | border-style:solid;">6 patients reported</span> | ||
+ | |||
+ | *[[Paclitaxel (Taxol)]] 120 mg/m2 in 500 mL 5% glucose solution IV once on day 1, given first | ||
+ | *[[Cisplatin (Platinol)]] 50 mg/m2 IV once per day on days 1 & 2 | ||
+ | *[[Fluorouracil (5-FU)]] 1000 mg/m2/day in 2 liters half normal 2.5% glucose saline IV continuous infusion on days 2 to 5 | ||
+ | |||
+ | '''21-day cycles'''; "two patients received more than the standard four courses" | ||
+ | |||
+ | Supportive medications: | ||
+ | *"Corticosteroids, antihistamines, and an H2 antagonist were administered before starting paclitaxel" | ||
+ | *"Antiemetic drugs and glutathione were administered before cisplatin" | ||
+ | *1 liter half normal 2.5% glucose saline with 20 mEq potassium chloride and 10 mEq magnesium sulfate (MgSO4) IV given twice, before and after cisplatin | ||
+ | |||
+ | ===References=== | ||
+ | # Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol. 2009 Mar;55(3):546-51. doi: 10.1016/j.eururo.2008.07.014. Epub 2008 Jul 14. [http://www.sciencedirect.com/science/article/pii/S030228380800835X link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18649992 PubMed] |
Revision as of 00:17, 29 July 2013
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
Adjuvant chemotherapy
TIP
No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "it is reasonable to give 4 courses of TIP in the adjuvant setting if it was not given preoperatively and the pathology shows high-risk features." (see neoadjuvant chemotherapy section)
Neoadjuvant chemotherapy
TIP
TIP: Taxol, Ifosfamide, Platinol
Regimen, Pagliaro, et al. 2010
Level of Evidence: Phase II
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
- Ifosfamide (Ifex) 1200 mg/m2 IV over 2 hours once per day on days 1 to 3
- Cisplatin (Platinol) 25 mg/m2 IV over 2 hours once per day on days 1 to 3
- Administered intravenously in 250 mL of normal saline containing 12.5 g of mannitol
- Mesna (Mesnex) 400 mg/m2 IV once before each dose of ifosfamide
- Mesna (Mesnex) 200 mg/m2 IV given twice, at 4 and 8 hours after each dose of ifosfamide
21 to 28-day cycles x 4 cycles; "cycle was repeated on day 22 if the patient's absolute neutrophil count was at least 1,400/μL and platelet count was at least 100,000/μL"
Supportive medications:
- After cisplatin, hydration with 3 liters of a solution of 5% dextrose, sodium chloride, potassium chloride, magnesium sulfate, and mannitol
- Either Dexamethasone (Decadron) 8 mg IV once 1 hour before paclitaxel, or Dexamethasone (Decadron) 20 mg PO given twice, at 12 and 6 hours before the paclitaxel
- Diphenhydramine (Benadryl) 50 mg IV once prior to paclitaxel
- One of the following H2 blockers:
- Cimetidine (Tagamet) 300 mg IV once prior to paclitaxel
- Ranitidine (Zantac) 50 mg IV once prior to paclitaxel
- Famotidine (Pepcid) 20 mg IV once prior to paclitaxel
- "The use of prophylactic granulocyte colony-stimulating factor was allowed but not required"
References
- Pagliaro LC, Williams DL, Daliani D, Williams MB, Osai W, Kincaid M, Wen S, Thall PF, Pettaway CA. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol. 2010 Aug 20;28(24):3851-7. doi: 10.1200/JCO.2010.29.5477. Epub 2010 Jul 12. link to original article contains verified protocol PubMed
Metastatic or unresectable disease
Cisplatin & Fluorouracil
Regimen, Shammas, et al. 1992
Level of Evidence: 8 patients reported, 2 with partial response
- Cisplatin (Platinol) 100 mg/m2 IV once once on day 1
- Fluorouracil (5-FU) 1000 mg/m2/day IV continuous infusion on days 1 to 5
References
- Shammas FV, Ous S, Fossa SD. Cisplatin and 5-fluorouracil in advanced cancer of the penis. J Urol. 1992 Mar;147(3):630-2. contains protocol PubMed
Cisplatin & Irinotecan
Regimen, Theodore, et al. 2008 (EORTC 30992)
Level of Evidence: Phase II
- Cisplatin (Platinol) 80 mg/m2 IV over 1 to 3 hours once on day 1, given second
- Irinotecan (Camptosar) 60 mg/m2 IV over 30 minutes once per day on days 1, 8, 15, given first
28-day cycles, with up to 4 cycles before surgery in the neoadjuvant setting for T3 or N1 to N2; up to 8 cycles for patients with T4, N3, or M+ distant metastatic disease
Supportive medications:
- Adequate hydration with cisplatin, per guidelines at each investigator's site
- Antiemetic medication per routine local practice.
- "Systematic premedication with atropine as of the first cycle of treatment was at the investigator's discretion but was not recommended."
References
- Theodore C, Skoneczna I, Bodrogi I, Leahy M, Kerst JM, Collette L, Ven K, Marréaud S, Oliver RD; EORTC Genito-Urinary Tract Cancer Group. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol. 2008 Jul;19(7):1304-7. link to original article contains verified protocol PubMed
Cisplatin, Methotrexate, Bleomycin
Regimen, Haas, et al. 1999 (SWOG 8520)
The NCCN, Penile Cancer version 1.2013, says that "bleomycin-containing regimens were associated with unacceptable toxicity and are no longer recommended."
Level of Evidence: Phase II
- Cisplatin (Platinol) 75 mg/m2 at a concentration of 1 mg/mL normal saline IV given at a rate of 1 mg/min once on day 1
- Methotrexate (MTX) 25 mg/m2 IV bolus once per day on days 1 & 8
- Bleomycin (Blenoxane) 10 units/m2 IV bolus once per day on days 1 & 8
- Chemotherapy with bleomycin was discontinued when a total cumulative dose of 200 units/m2 was reached
21-day cycles, given until disease progression; patients who achieved complete remission discontinued therapy after 6 cycles
Supportive medications:
- Normal saline IV at 250 mL/hour, starting 1 hour before cisplatin and continued at least 6 hours after cisplatin.
- Furosemide (Lasix) 40 mg IV once prior to cisplatin
References
- Haas GP, Blumenstein BA, Gagliano RG, Russell CA, Rivkin SE, Culkin DJ, Wolf M, Crawford ED. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999 Jun;161(6):1823-5. link to original article contains verified protocol PubMed
Paclitaxel (Taxol)
Regimen, Di Lorenzo, et al. 2011
Level of Evidence: Phase II
- Paclitaxel (Taxol) 175 mg/m2 IV over 3 hours once on day 1
21-day cycles, administered until disease progression or unacceptable toxicity
Supportive medications:
- G-CSF could be used in later cycles if the patient developed febrile neutropenia during treatment
- Dexamethasone (Decadron) 8 mg PO given three times, at 12 hours before, immediately before, and 12 hours after paclitaxel
References
- Di Lorenzo G, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, Perdonà S, Ferro M, Rescigno P, D'Aniello C, Matano E, Altieri V, Palmieri G, Imbimbo C, De Placido S, Mirone V. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011 Dec;60(6):1280-4. link to original article contains verified protocol PubMed
TIP
No primary reference available, but the NCCN, Penile Cancer version 1.2013, says that "TIP is a reasonable first-line treatment for patients with metastatic penile cancer." (see neoadjuvant chemotherapy section)
TPF
TPF: Taxol, Platinol, Fluorouracil
Regimen, Pizzocaro, et al. 2009
Level of Evidence: 6 patients reported
- Paclitaxel (Taxol) 120 mg/m2 in 500 mL 5% glucose solution IV once on day 1, given first
- Cisplatin (Platinol) 50 mg/m2 IV once per day on days 1 & 2
- Fluorouracil (5-FU) 1000 mg/m2/day in 2 liters half normal 2.5% glucose saline IV continuous infusion on days 2 to 5
21-day cycles; "two patients received more than the standard four courses"
Supportive medications:
- "Corticosteroids, antihistamines, and an H2 antagonist were administered before starting paclitaxel"
- "Antiemetic drugs and glutathione were administered before cisplatin"
- 1 liter half normal 2.5% glucose saline with 20 mEq potassium chloride and 10 mEq magnesium sulfate (MgSO4) IV given twice, before and after cisplatin
References
- Pizzocaro G, Nicolai N, Milani A. Taxanes in combination with cisplatin and fluorouracil for advanced penile cancer: preliminary results. Eur Urol. 2009 Mar;55(3):546-51. doi: 10.1016/j.eururo.2008.07.014. Epub 2008 Jul 14. link to original article contains verified protocol PubMed