Dr. Asif Muneer
Dr. Muneer, a urologic surgeon and andrologist at the University College London Hospitals and a senior lecturer at the University College London, said that immune checkpoint inhibitors are being developed that might offer effective treatment options for patients with advanced penile cancer.
“When it’s advanced, penile cancer is often resistant or responds poorly to chemotherapy, and, therefore, we have to look at alternative options. Immunotherapy offers that potential alternative,” Dr. Muneer said.
Although more clinical trials of these inhibitors are needed, recent genomic research has offered a more precise indicator of which mutations are present in a patient with advanced penile cancer. This makes a targeted treatment approach possible.
“We’ve now performed whole exome sequencing and methylation studies in penile cancer at University College London,” Dr. Muneer said. “This provides a genetic signature for a patient, which can tell oncologists and surgeons the likelihood of the microscopic spread of cancer and whether potential targets exist for therapies including immunotherapy.”
Although his lecture will focus more on the epidemiology and potential immunotherapies in advanced disease, Dr. Muneer said Genitourinary Cancers Symposium attendees shouldn’t neglect the importance of surgical advances made this year, especially in penile cancer.
“Advances in surgical techniques, which have mostly been modifications of standard operations, have improved the cosmetic outcomes and functionality in patients after partial penectomy. These advances have also improved the outcome of minimally invasive surgical techniques,” Dr. Muneer said.
Even though surgical improvements were crucial in 2016, Dr. Muneer predicts non-surgical treatments will be the focus of 2017. In particular, he thinks clinical trials will attempt to both identify more precise therapeutic targets for immunotherapies and determine how to use molecular biomarkers to predict how patients with advanced cancer will respond to these alternative treatments.
In general, Dr. Muneer said research in 2017 will continue to be patient focused, specifically on patients with advanced-stage cancers, as there have been few improvements made over the past 30 years with respect to treatment outcomes.
“The message is that with a subset of patients, we haven’t made much of a difference, even though patients with early-stage penile cancer or minimal disease in their lymph nodes do well in the long term,” Dr. Muneer said.