Difference between revisions of "Penile cancer"

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(added regimens)
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==TIP==
 
==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)
 
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)
 +
 +
==TPF (Docetaxel)==
 +
TPF: '''<u>T</u>'''axotere, '''<u>P</u>'''latinol, '''<u>F</u>'''luorouracil
 +
 +
===Regimen, Necchi, et al. 2011===
 +
''Necchi, et al. 2011 is a case report.''
 +
 +
Level of Evidence:
 +
<span
 +
style="background:#ff0000;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Case report</span>
 +
 +
*[[Docetaxel (Taxotere)]] 75 mg/m2 IV once on day 1
 +
*[[Cisplatin (Platinol)]] 75 mg/m2 IV once on day 1
 +
*[[Fluorouracil (5-FU)]] 750 mg/m2/day IV continuous infusion on days 1 to 4
 +
 +
'''21-day cycles x 3 cycles'''
 +
 +
===References===
 +
# Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. doi: 10.1200/JCO.2011.34.8367. Epub 2011 May 31. [http://jco.ascopubs.org/content/29/22/e650.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21632506 PubMed]
  
 
=Neoadjuvant chemotherapy=
 
=Neoadjuvant chemotherapy=
Line 44: Line 67:
 
===References===
 
===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. [http://jco.ascopubs.org/content/28/24/3851.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20625118 PubMed]
 
# 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. [http://jco.ascopubs.org/content/28/24/3851.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/20625118 PubMed]
 +
 +
==VBM==
 +
VBM:  '''<u>V</u>'''incristine, '''<u>B</u>'''leomycin, '''<u>M</u>'''ethotrexate
 +
 +
===Regimen, Pizzocaro, et al. 1988 & Pagliaro, et al. 2009===
 +
''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:
 +
<span
 +
style="background:#ff0000;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">12-patient report</span>
 +
 +
''Limited information about this is available since Pizzocaro, et al. 1988 is not available online, and Pagliaro, et al. 2009 is a review article which does not include complete details about the regimen.''
 +
*[[Bleomycin (Blenoxane)]] 30 mg IM once per week
 +
*[[Vincristine (Oncovin)]] 1 mg IV once per week
 +
*[[Methotrexate (MTX)]] 30 mg PO once per week
 +
 +
'''12-week course'''
 +
 +
===References===
 +
# Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol. 1988;27(6b):823-4. '''contains protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/2466471 PubMed]
 +
# '''Review''': Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. doi: 10.1007/s00345-008-0310-z. Epub 2008 Aug 6. [http://link.springer.com/article/10.1007%2Fs00345-008-0310-z link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18682961 PubMed]
  
 
=Metastatic or unresectable disease=
 
=Metastatic or unresectable disease=
 +
 +
==BMP, MPB==
 +
BMP: '''<u>B</u>'''leomycin, '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol
 +
<br>MPB: '''<u>M</u>'''ethotrexate, '''<u>P</u>'''latinol, '''<u>B</u>'''leomycin
 +
 +
===Regimen #1, 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:
 +
<span
 +
style="background:#EEEE00;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Phase II</span>
 +
 +
*[[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
 +
*[[Methotrexate (MTX)]] 25 mg/m2 IV bolus once per day on days 1 & 8
 +
*[[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
 +
 +
'''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
 +
 +
===Regimen #2, Corral, et al. 1998 & Pagliaro, et al. 2009===
 +
''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:
 +
<span
 +
style="background:#EEEE00;
 +
padding:3px 6px 3px 6px;
 +
border-color:black;
 +
border-width:2px;
 +
border-style:solid;">Phase II</span>
 +
 +
''21 of 29 evaluable patients in Corral, et al. 1998 had penile cancer.  Please see the paper for additional variations in the protocol, including some patients being treated with intraarterial therapy.'' 
 +
*[[Bleomycin (Blenoxane)]] 10 mg/m2 IV once per day on days 2 to 6 (note: Pagliaro, et al. 2009 lists a "dosage of 50 mg/m2 on days 2-6," which could be misinterpreted as 50 mg/m2 for each dose, which is in contrast to the 50 mg/m2 for each cycle that Corral, et al. 1998 describes.)
 +
*[[Methotrexate (MTX)]] 200 mg/m2 IV once per day on days 1, 15, 22
 +
*[[Folinic acid (Leucovorin)]] 25 mg PO every 6 hours x 12 doses, starting 24 hours after each dose of methotrexate
 +
*[[Cisplatin (Platinol)]] 20 mg/m2 IV over 3 hours once per day on days 2 to 6 (note: Corral, et al. 1998 does not specify which days cisplatin is given on.  Pagliaro, et al. 2009 specifies that cisplatin is given on days 2 to 6.  For Corral, et al. 1998, the 5 day course is inferred based on the paper saying that the total dosage--presumably per cycle--was 100 mg/m2.)
 +
 +
'''28-day cycles'''
 +
 +
===References===
 +
# Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol. 1998 Nov;160(5):1770-4. [http://www.jurology.com/article/S0022-5347%2801%2962402-9/abstract link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/9783949 PubMed]
 +
# 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] content property of [http://hemonc.org HemOnc.org]
 +
# '''Review''': Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. doi: 10.1007/s00345-008-0310-z. Epub 2008 Aug 6. [http://link.springer.com/article/10.1007%2Fs00345-008-0310-z link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/18682961 PubMed]
  
 
==Cisplatin & Fluorouracil==
 
==Cisplatin & Fluorouracil==
Line 59: Line 157:
 
*[[Cisplatin (Platinol)]] 100 mg/m2 IV once once on day 1
 
*[[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
 
*[[Fluorouracil (5-FU)]] 1000 mg/m2/day IV continuous infusion on days 1 to 5
 +
 +
(unable to retrieve full article for further details)
  
 
===References===
 
===References===
Line 86: Line 186:
 
# 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]
 
# 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==
+
==Paclitaxel (Taxol)==
===Regimen, Haas, et al. 1999 (SWOG 8520)===
+
===Regimen, Di Lorenzo, et al. 2011===
''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 98: Line 196:
 
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
+
*[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours 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'''
+
'''21-day cycles, administered until disease progression or unacceptable toxicity'''
  
 
Supportive medications:
 
Supportive medications:
*Normal saline IV at 250 mL/hour, starting 1 hour before cisplatin and continued at least 6 hours after cisplatin.
+
*[[Filgrastim (Neupogen)|G-CSF]] could be used in later cycles if the patient developed febrile neutropenia during treatment
*Furosemide (Lasix) 40 mg IV once prior to cisplatin
+
*[[Dexamethasone (Decadron)]] 8 mg PO given three times, at 12 hours before, immediately before, and 12 hours after paclitaxel
  
 
===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]
+
# 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]
 +
 
 +
==Panitumumab (Vectibix)==
 +
 
 +
===Regimen, Necchi, et al. 2011===
 +
''Necchi, et al. 2011 is a case report.''
  
==Paclitaxel (Taxol)==
 
===Regimen, Di Lorenzo, et al. 2011===
 
 
Level of Evidence:
 
Level of Evidence:
 
<span  
 
<span  
style="background:#EEEE00;
+
style="background:#ff0000;
 
padding:3px 6px 3px 6px;
 
padding:3px 6px 3px 6px;
 
border-color:black;
 
border-color:black;
 
border-width:2px;
 
border-width:2px;
border-style:solid;">Phase II</span>
+
border-style:solid;">Case report</span>
  
*[[Paclitaxel (Taxol)]] 175 mg/m2 IV over 3 hours once on day 1
+
*[[Panitumumab (Vectibix)]] 6 mg/kg IV once on day 1
  
'''21-day cycles, administered until disease progression or unacceptable toxicity'''
+
'''14-day cycles'''
 
 
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 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]
+
# Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. doi: 10.1200/JCO.2011.34.8367. Epub 2011 May 31. [http://jco.ascopubs.org/content/29/22/e650.long link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/21632506 PubMed]
  
 
==TIP==
 
==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)
 
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 (Paclitaxel)==
 
TPF: '''<u>T</u>'''axol, '''<u>P</u>'''latinol, '''<u>F</u>'''luorouracil
 
TPF: '''<u>T</u>'''axol, '''<u>P</u>'''latinol, '''<u>F</u>'''luorouracil
  

Revision as of 04:03, 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)

TPF (Docetaxel)

TPF: Taxotere, Platinol, Fluorouracil

Regimen, Necchi, et al. 2011

Necchi, et al. 2011 is a case report.

Level of Evidence: Case report

21-day cycles x 3 cycles

References

  1. Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. doi: 10.1200/JCO.2011.34.8367. Epub 2011 May 31. link to original article contains verified protocol PubMed

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

  1. 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

VBM

VBM: Vincristine, Bleomycin, Methotrexate

Regimen, Pizzocaro, et al. 1988 & Pagliaro, et al. 2009

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: 12-patient report

Limited information about this is available since Pizzocaro, et al. 1988 is not available online, and Pagliaro, et al. 2009 is a review article which does not include complete details about the regimen.

12-week course

References

  1. Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol. 1988;27(6b):823-4. contains protocol PubMed
  2. Review: Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. doi: 10.1007/s00345-008-0310-z. Epub 2008 Aug 6. link to original article contains verified protocol PubMed

Metastatic or unresectable disease

BMP, MPB

BMP: Bleomycin, Methotrexate, Platinol
MPB: Methotrexate, Platinol, Bleomycin

Regimen #1, 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

  • 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
  • Methotrexate (MTX) 25 mg/m2 IV bolus once per day on days 1 & 8
  • 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

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

Regimen #2, Corral, et al. 1998 & Pagliaro, et al. 2009

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

21 of 29 evaluable patients in Corral, et al. 1998 had penile cancer. Please see the paper for additional variations in the protocol, including some patients being treated with intraarterial therapy.

  • Bleomycin (Blenoxane) 10 mg/m2 IV once per day on days 2 to 6 (note: Pagliaro, et al. 2009 lists a "dosage of 50 mg/m2 on days 2-6," which could be misinterpreted as 50 mg/m2 for each dose, which is in contrast to the 50 mg/m2 for each cycle that Corral, et al. 1998 describes.)
  • Methotrexate (MTX) 200 mg/m2 IV once per day on days 1, 15, 22
  • Folinic acid (Leucovorin) 25 mg PO every 6 hours x 12 doses, starting 24 hours after each dose of methotrexate
  • Cisplatin (Platinol) 20 mg/m2 IV over 3 hours once per day on days 2 to 6 (note: Corral, et al. 1998 does not specify which days cisplatin is given on. Pagliaro, et al. 2009 specifies that cisplatin is given on days 2 to 6. For Corral, et al. 1998, the 5 day course is inferred based on the paper saying that the total dosage--presumably per cycle--was 100 mg/m2.)

28-day cycles

References

  1. Corral DA, Sella A, Pettaway CA, Amato RJ, Jones DM, Ellerhorst J. Combination chemotherapy for metastatic or locally advanced genitourinary squamous cell carcinoma: a phase II study of methotrexate, cisplatin and bleomycin. J Urol. 1998 Nov;160(5):1770-4. link to original article contains verified protocol PubMed
  2. 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 content property of HemOnc.org
  3. Review: Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009 Apr;27(2):221-5. doi: 10.1007/s00345-008-0310-z. Epub 2008 Aug 6. link to original article contains verified protocol PubMed

Cisplatin & Fluorouracil

Regimen, Shammas, et al. 1992

Level of Evidence: 8 patients reported, 2 with partial response

(unable to retrieve full article for further details)

References

  1. 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

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

  1. 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

Paclitaxel (Taxol)

Regimen, Di Lorenzo, et al. 2011

Level of Evidence: Phase II

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

  1. 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

Panitumumab (Vectibix)

Regimen, Necchi, et al. 2011

Necchi, et al. 2011 is a case report.

Level of Evidence: Case report

14-day cycles

References

  1. Necchi A, Nicolai N, Colecchia M, Catanzaro M, Torelli T, Piva L, Salvioni R. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol. 2011 Aug 1;29(22):e650-2. doi: 10.1200/JCO.2011.34.8367. Epub 2011 May 31. 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 (Paclitaxel)

TPF: Taxol, Platinol, Fluorouracil

Regimen, Pizzocaro, et al. 2009

Level of Evidence: 6 patients reported

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

  1. 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