ASCO GU 2017: Orphan Cancers with Opportunities for Improved Treatment: Genomic profiling of penile squamous cell carcinoma reveals new opportunities for targeted therapy

Orlando, Florida USA (UroToday.com) Dr. Scott Tomlins from the University of Michigan summarized the current understanding of the genomic landscape of penile squamous cell carcinoma (SCC). There has been an abundance of evidence for the frequency of EGFR amplification mutations across several cohorts of penile cancer patients. Dr. Tomlins points out that while EGFR mutation has been recognized as a key driver mutation, copy number variations in the primary and metastatic lesions has been underappreciated. Due to its pivotal role in prognostication and therapeutic targeting, accurate characterization at specific lesion sites is important. An unexpected finding is the difference between the genomic alterations found in penile SCC and those found in other HPV driven SCC’s. Instead, the mutational patterns resemble those found in SCC’s of the lung and head and neck. Strides have also been made in defining the mutational evolution in penile SCC. Multiple p53 mutations were found in squamous carcinoma in situ, a precursor to penile SCC. Further, several mutations have been found prior to evidence of malignant invasion. Of important therapeutic implication, PD-L1 expression has been described in penile SCC. In addition, PD-L1 expression was linked to compromise in survival. Despite this, no PD-L1 trial has yet been launched for the treatment of penile SCC. Throughout his talk, Dr. Tomlins emphasized the complexity between genomic alterations and clinical course. Instead of the naïve preconception of direct correlation between specific mutations and cancer, we are only beginning to see the contours of the complex web of interactions between the myriad genomic alterations and oncogenesis.

Presenter: Scott Tomlins, MD, University of Michigan

Written By: Roger Li, MD, Urologic Oncology Fellow, Department of Urology, UT MD Anderson Cancer Center, Houston, TX, Ashish M. Kamat, MD, MBBS, FACS, Wayne B. Duddlesten Professor, Department of Urology, UT MD Anderson Cancer Center, Houston TX

at the 2017 Genitourinary Cancers Symposium - February 16 - 18, 2017 – Orlando, Florida USA

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