Comparison of efficacy and toxicity of chemotherapeutic regimens used as adjuvant and/or neoadjuvant chemotherapy in penile cancer patients

Objective: To compare the efficacy and toxicity of different chemotherapeutic regimens used as adjuvant or neoadjuvant chemotherapy in penile cancer patients. Methodology: This observational study was carried out at Mahavir Cancer Sansthan & Research Centre (MCSRC), Patna, involving 112 patients who received various chemotherapy regimens: 5Fluorouracil with Cisplatin (FP), Paclitaxel with Carboplatin (TP1), Paclitaxel with Cisplatin (TP2), and Paclitaxel with Ifosfamide and Cisplatin (TIP). Efficacy was assessed based on tumor response after Neoadjuvant Chemotherapy (NACT) using RECIST v1.1, and Disease-Free Survival (DFS) was calculated with the Kaplan-Meier method. Chemotherapy toxicity was evaluated using CTCAE v4.03, and statistical analysis was performed with SPSS v22. Results: The mean age of the penile cancer patients was found to be 53.5 years. The most of the patients comes under stage-IIIb (62 patients - 55.4%). Out of 88 FP received patients, 28 were treated with NACT in which 24 had partial response (PR) and 4 had progressive disease (PD). The objective response rate (ORR) for this group was found to be 85.71%. Out of 21 TP1 received patients, 9 were treated with NACT in which 6 had CR and 3 had PR, therefore ORR was found to be 100%. Only one Patient received TIP as NACT had PR. The median DFS rate was found to be 6 months for ACT and 7 months for NACT in FP chemotherapy, whereas 10 months was found to be for ACT and NACT of TP1 combinations. The patients received TP1 combinations, had more than 6 months of DFS rate. The grade I-III haematological toxicity of anaemia, lymphocytopenia and thrombocytopenia was observed more in FP than TP1 and TP2 combinations. The grade I-III non- haematological toxicity was showed for all chemotherapy combinations. Conclusion: Overall, the TP1 regimen stands out as the most effective and well-tolerated chemotherapy regimen for penile cancer, demonstrating both superior survival outcomes and a more favourable toxicity profile compared to the FP regimen.