Penile squamous cell carcinoma (PSCC) represents a malignancy with low incidence. Despite advances in chemotherapy-based management, outcomes for patients with locally advanced and metastatic disease remain poor, with 5-year survival rates of 51% and 9%, respectively. Early diagnosis is crucial, yet psychosocial/structural barriers often delay it. Treatment strategies are stage-dependent, ranging from organ-sparing surgery and targeted radiotherapy for early-stage disease to cisplatin-based chemotherapy for locally advanced and metastatic cases. However, systemic therapies provide modest survival benefits and can expose the patient to unnecessary toxicities. Immunotherapy has emerged as a promising area, given the high expression of PD-L1 in PSCC and the significant proportion of HPV-driven tumors. Although initial results from immunotherapy-based trials are limited, preliminary trials such as HERCULES, ALPACA, PULSE, and PERICLES aim to define their role better. Similarly, combination regimens utilizing toripalimab in combination with nimotuzumab and taxane-based chemotherapy (TNT) followed by consolidative surgery are currently underway. Furthermore, the development of therapeutic HPV vaccines offers a novel strategy to enhance local antitumor immunity. Antibody–drug conjugates (ADCs) targeting HER-2, Trop-2, and Nectin-4 antigens represent another evolving therapeutic avenue that has shown preliminary promising results. As the landscape of penile cancer treatment continues to grow, incorporating these novel strategies could further improve survival outcomes and/or offer improved quality of life. This review provides a comprehensive overview of emerging systemic therapies in PSCC, underscoring ongoing research efforts to address unmet needs.
阴茎鳞状细胞癌（PSCC）是一种发病率较低的恶性肿瘤。尽管以化疗为基础的治疗手段有所进展，但局部晚期和转移性患者的预后仍然较差，其5年生存率分别为51%和9%。早期诊断至关重要，但社会心理及结构性障碍常导致诊断延迟。治疗策略取决于疾病分期，早期疾病可采用保留器官的手术和靶向放疗，局部晚期及转移性病例则需采用以顺铂为基础的化疗。然而，系统性治疗带来的生存获益有限，且可能使患者承受不必要的毒性反应。鉴于PSCC中PD-L1的高表达以及HPV驱动肿瘤占相当比例，免疫治疗已成为一个前景广阔的领域。尽管基于免疫治疗的临床试验初步结果有限，但诸如HERCULES、ALPACA、PULSE和PERICLES等初步试验旨在更明确地界定其作用。同时，采用特瑞普利单抗联合尼妥珠单抗及紫杉烷类化疗（TNT）并后续进行巩固手术的联合方案研究正在进行中。此外，治疗性HPV疫苗的开发为增强局部抗肿瘤免疫提供了新策略。针对HER-2、Trop-2和Nectin-4抗原的抗体偶联药物（ADCs）代表了另一个不断发展的治疗方向，并已显示出初步积极成果。随着阴茎癌治疗领域的持续发展，整合这些新型策略有望进一步提升生存结局和/或改善患者生活质量。本综述全面概述了PSCC新兴的系统性治疗方法，强调了为满足未竟医疗需求而持续进行的研究努力。
Evaluating the Evolving Treatment Landscape of Systemic Therapies in Penile Cancer
肿瘤(癌症)患者之家