A neoadjuvant (before surgery) combination of Taxol® (paclitaxel), Ifex® (ifosfamide), and Platinol® (cisplatin) produced clinically significant responses in patients with bulky regional lymph node metastases from penile cancer, according to the results of a study published in the Journal of Clinical Oncology.
Squamous cell carcinoma of the penis is relatively uncommon in the United States, with about 1,400 cases diagnosed annually. The disease, however, is more prevalent in Africa, South America, and Asia, and an estimated 26,000 new cases are diagnosed annually worldwide. Men with regional lymph node involvement have low survival rates. Because of its rarity, there is limited information regarding multimodality treatment for metastatic penile cancer.
The current study involved 30 men with Stage III or IV penile cancer with regional lymph node involvement but no distant metastases. All men underwent four courses of neoadjuvant chemotherapy (prior to surgery) with a combination of Taxol/Ifex/Platinol. Fifty percent of men experienced an objective response from the therapy, and 73% subsequently underwent surgery.
After a median follow-up of 34 months, nine patients (30%) remained alive and free of recurrence and two patients had died of other causes without recurrence. The researchers concluded that a neoadjuvant combination of Taxol/Ifex/Platinol was effective in terms of the conventional response rate, time to disease progression, and overall survival. The regimen produced a pathologic complete response in 10% of patients. The researchers recommend the neoadjuvant regimen for men with regional metastatic penile cancer.
 Pagliaro LC, Williams DL, Daliani D, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: A phase II study. Journal of Clinical Oncology. Published early online July 19, 2010.