Trajectories of squamous cell carcinoma antigen and outcomes of patients with advanced penile cancer after chemotherapy based on paclitaxel, ifosfamid, and cisplatin regimen

TL;DR

This study shows that changes in SCC-A levels during chemotherapy predict outcomes in advanced penile cancer patients.

Contribution

Identifies SCC-A trajectories as a novel prognostic tool for penile cancer chemotherapy outcomes.

Findings

High-decline SCC-A trajectory correlates with worse survival and tumor response in penile cancer patients.

SCC-A levels can predict objective and pathological response rates to TIP chemotherapy.

SCC-A trajectories may aid in monitoring tumor response after systemic therapies.

Abstract

Penile cancer (PC) is a lethal malignancy with no effective prognostic biomarker. We aim to investigate associations between trajectories of squamous cell carcinoma antigen (SCC‐A) and patient outcomes after chemotherapy based on paclitaxel, ifosfamid, and cisplatin (TIP) regimen.

Consecutive AJCC staging III/IV PC patients who received TIP chemotherapy and repeated SCC‐A measurements in 2014–2022 were analyzed. Latent class growth mixed (LCGM) models were employed to characterize patients' serum SCC‐A trajectories. Patient survival, and clinical and pathological tumor responses were compared. Inverse probability treatment weighting was used to adjust confounding factors.

Eighty patients were included. LCGM models identified two distinct trajectories of SCC‐A: low‐stable (40%; n = 32) and high‐decline (60%; n = 48). Overall survival (HR [95% CI]: 3.60 [1.23–10.53], p = 0.019), progression‐free survival (HR [95% CI]: 11.33 [3.19–40.3], p < 0.001), objective response rate (37.5% vs. 62.5% p = 0.028), disease control rate (60.4% vs. 96.9% p < 0.00), and pathological complete response rate (21.2% vs. 51.9%, p = 0.014) were significantly worse in the high‐decline arm.

PC patients' SCC‐A change rate was associated with tumor response and patient survival after TIP chemotherapy. SCC‐A might assist tumor monitoring after systemic therapies.

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