Review – Penile CancerThe Role of Human Papilloma Virus in Penile Cancer Prevention and New Therapeutic Agents
Section snippets
Primary prevention
Primary prevention describes measures and interventions to prevent negative health effects before they occur, such as altering risky behavior or exposure to noxious substances. Therefore, prophylactic vaccination against HPV is counted to the primary prevention strategies.
Of more than 210 known subtypes of HPV, only 20–40 of these typically cause anogenital infections in humans [8]. In 2006, a quadrivalent HPV vaccine was licensed in the USA, followed by a bivalent vaccine in 2009 and a
Secondary prevention
Secondary prevention aims to diagnose a disease at subclinical or early clinical stage. In addition, it tries to halt or slow down the disease progression to higher or advanced stages. This is typically achieved by screening programs (eg, Pap smear screening to reduce death rates from cervical cancer). Even in developed countries, no screening programs for penile cancer exist and the awareness of the population for that rare disease is low. Besides primary prevention in terms of information
Tertiary prevention
Tertiary prevention aims to reduce long-term negative effects of a disease (eg, by rehabilitation programs or follow-up). Surgical treatment of invasive penile cancer and new systemic agents might be subsumed under this level of prevention.
One of the most promising approaches to HPV disease is therapeutic HPV vaccines.
Cancer cells do not express appreciable levels of L1 capsid antigen; therefore, the mode of action has to be different than that for prophylactic vaccines. Besides the capsid
Conclusions
Treatment in the early stages of penile cancer is crucial for good long-term results and predominantly preserves quality of life by preserving normal sexual function.
More important in this point of view is an increased awareness for primary and secondary prevention of penile cancer is (Table 1).
New therapeutic agents, especially therapeutic HPV vaccines, are urgently awaited but not yet ready for routine clinical use.
Author contributions: Boris Schlenker had full access to all the data in the
References (23)
- et al.
HPV infection and immunochemical detection of cell-cycle markers in verrucous carcinoma of the penis
Mod Pathol
(2009) - et al.
Detection and typing of human papillomavirus DNA in penile carcinoma: evidence for multiple independent pathways of penile carcinogenesis
Am J Pathol
(2001) - et al.
Genital HPV infection and related lesions in men
Prev Med
(2011) - et al.
A review of clinical trials of human papillomavirus prophylactic vaccines
Vaccine
(2012) - et al.
Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial
Lancet Oncol
(2005) - et al.
Cervical cancer – State of the science: From angiogenesis blockade to checkpoint inhibition
Gynecol Oncol
(2018) - et al.
Human papillomavirus is a necessary cause of invasive cervical cancer worldwide
J Pathol
(1999) - et al.
Systematic review of human papillomavirus prevalence in invasive penile cancer
Cancer Causes Control
(2009) WHO Classification of Tumours of the Urinary System and Male Genital Organs
(2016)- et al.
Chapter 1: HPV in the etiology of human cancer
Vaccine
(2006)
HPV vaccination in boys and men
Hum Vaccin Immunother
Cited by (17)
Premalignant lesions of the penis
2021, SemergenProfound and durable responses with PD-1 immune checkpoint inhibitors in patients with metastatic penile squamous cell carcinoma
2021, Current Problems in Cancer: Case ReportsCitation Excerpt :Up to 50% of invasive penile carcinomas are HPV-related, usually the high-risk types HPV 16 or 18. ( Schlenker and Schneede, 2019) It is known from other tumor entities, especially from head and neck cancers – which share histologic and pathogenic characteristics with penile cancers, that HPV positive tumors can be susceptible to immunotherapy. ( Ferris et al., 2016; Buonerba et al., 2017) This susceptibility might be based on the central role of cytotoxic T-lymphocytes, the primary cell type involved in cellular immune response against antigens associated with cellular transformation in HPV-driven cancers. (
Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis
2024, International Journal of Impotence ResearchSafety and efficacy of immune checkpoint inhibitors in advanced penile cancer: Report from the Global Society of Rare Genitourinary Tumors
2023, Journal of the National Cancer InstituteCemiplimab as First Line Therapy in Advanced Penile Squamous Cell Carcinoma: A Real-World Experience
2023, Journal of Personalized Medicine