The Relationship Between HPV Status and Chemoradiotherapy in the Locoregional Control of Penile Cancer - Beyond the Abstract

The manuscript is timely in that, while the status of HPV infection in oropharyngeal cancer (OPCa) is becoming better defined, and is beginning to modify therapy, the case is not true for penile cancer (PeCa).  The latter is much less common and data on clinical and viral interactions far fewer.

The manuscript attempts to expand knowledge in that arena.  While a selection of 51 patients seems small, it is large when it pertains to PeCa patients for whom both clinical outcomes and HPV status are available.  Thus is it not surprising that HPV status was not associated with better outcomes in the entire population.  As expected from our clinical experience the overwhelming driver of poor outcome was positive nodal status.

HPV status was associated with improved outcome in the cohort of patients with pathologically positive lymph nodes (pN+) patients, as was delivery of chemoradiotherapy.  These data do mirror the OPCa experience.  Interestingly in the cadre of HPV+ patients, local-regional control was improved by chemoradiation (p=0.038).  Absent a survival advantage, we posit this to be due to altered radiosensitivity in the HPV+ cohort.  Further genomic analysis is ongoing by our group.

Written by: Zhigang Yuan, MD, Ph.D1, Anna R. Giuliano, Ph.D2, Philippe E. Spiess, MD3, Peter A. S. Johnstone, MD., FACR, FASTRO4
1. Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
2. Department of Cancer Epidemiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
3. Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL
4. Senior Member and Vice Chair, Radiation Oncology, Senior Member, Health Outcomes & Behavior, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL

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