Search

Leone et al. describe management strategies for patients with penile cancer and metastasis to regional lymph nodes. They review the prognostic factors, indications for lymphadenectomy, surgical techniques and the role of systemic chemotherapy, radiotherapy and new targeted and immunotherapeutic approaches.

Current advances in the understanding of penile carcinogenesis provide the possibility for new personalized and actionable targeted therapeutic approaches to improve outcomes in men with advanced penile cancer. Targeting the human epidermal growth factor receptor pathway showed promising results in a recent phase II trial of first-line therapy with dacomitinib.

Cryotherapy has the potential to treat recurrent prostate cancer after primary radiotherapy fails. Oncological and functional outcomes of focal versus whole-gland salvage cryotherapy have been examined in a recent study, which demonstrated a positive effect of focal cryotherapy on reducing serum PSA with improved potency and incontinence rates compared with the whole-gland technique.

In a phase 1b trial, treatment of patients with muscle-invasive bladder cancer with intravesical oncolytic virus cretostimogene grenadenorepvec in combination with nivolumab was safe and led to encouraging preliminary clinical response rates.

Treatment options in patients with unresectable advanced penile cancer are limited owing to a lack of large, randomized prospective studies. A recent multicentre trial evaluated the use of gemcitabine plus cisplatin in such patients but the results were disappointing. What is the future of systemic therapy for advanced penile cancer?

Management of rare genitourinary malignancies often depends on individual physicians’ discretion, resulting in non-standardized care. Furthermore, patients experience worse clinical outcomes than patients with common malignancies. Collaborative efforts such as the Global Society of Rare Genitourinary Tumors (GSRGT) are therefore necessary.

Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.

In this Review, the authors summarize the biological features of low-grade non-muscle-invasive bladder cancer, clinical risk stratification and evidence supporting treatment strategies. They also highlight contemporary developments in monitoring and therapeutic technologies.

Centralization of care for penile cancer has been underscored in the 2023 updated EAU–ASCO guidelines. Expertise consolidation enhances patient care, addressing penile cancer complexities from diagnosis to treatment. Centralization initiatives, like the European Reference Networks, and dedicated scientific societies have crucial roles in guiding centralized care pathways to ultimately improve patient outcomes.

Adoptive cell therapy using tumour-infiltrating lymphocytes (TILs) can enhance immune-based therapies and could be applied to genitourinary cancers. Advances in TIL manufacturing, optimization and delivery methodologies have the potential to improve the safety and efficacy of TIL therapy in the management of advanced genitourinary malignancies. In this Perspective, the authors consider how and why TIL therapy warrants evaluation in clinical trials treating patients with genitourinary cancers.

In this Review, Aydin et al. discuss our current knowledge of the genomic, molecular and immunological make-up of penile squamous cell carcinoma and the findings of research studies to explore future therapeutic approaches in this disease.

Penile cancer is a growing health-care concern worldwide. Despite its rarity, penile cancer has a disproportionate impact on some countries, as the location with the highest incidences are invariably those with low resources and few registries or trials. In this Perspective, the authors discuss how global collaboration and centralization of care can help to improve management of penile cancer worldwide, but especially in areas where resources are limited.

This Primer discusses the epidemiology of penile cancer and mechanisms underlying its development, including HPV infection. The authors explain contemporary and possible future diagnostic and management approaches in localized and advanced disease and highlight important considerations around the quality of life of affected patients.

Non-invasive liquid biopsies such as plasma circulating tumour DNA (ctDNA) and urinary tumour DNA (utDNA) are promising tools for urothelial carcinoma diagnosis and management. In this Review, the authors provide an overview of the different liquid biopsy technologies available, and discuss the current state as well as future perspectives of ctDNA and utDNA application in urothelial carcinoma clinical care.

In this Review, Joshi and colleagues describe the immune landscape of penile cancer, examine existing and novel immune-based therapeutic targets, and discuss the future directions of immune-based therapies in penile cancer based on preclinical and clinical studies.