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Node-positive and metastatic penile cancer: lines of therapy

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5 standard-of-care settings across 5 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersHPV
Early / localised1·
Locally advanced1·
Advanced, first line1·
Second line·1
Other settings1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersPositive sentinel node or resectable palpable nodesRadical inguinal lymphadenectomy; pelvic lymphadenectomy when two or more inguinal nodes are involved or extranodal extension is found.68

Locally advanced

SubgroupSettingApproachProducts and trialsEvidence
All comersBulky or fixed inguinal nodesNeoadjuvant TIP chemotherapy (paclitaxel, ifosfamide, cisplatin) followed by lymphadenectomy in responders; chemoradiotherapy as an alternative within InPACT.94

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersMetastatic diseasePlatinum-based chemotherapy (TIP, paclitaxel-cisplatin, or with fluorouracil); PD-1 antibodies in trials or later lines (pembrolizumab, cemiplimab).99

Second line

SubgroupSettingApproachProducts and trialsEvidence
HPVHPV 16-positive recurrent diseaseTrials of HPV-directed vaccines with checkpoint inhibition (TG4001 with avelumab).24

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersAfter lymphadenectomy with pelvic nodes or extranodal extensionAdjuvant chemotherapy or chemoradiotherapy, ideally within InPACT because the benefit is unproven.93

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.