Treatment Outcomes of Penile intra-epithelial neoplasia (PeIN) related to P16 status
BAUS ePoster online library. Ashley S. Jun 24, 2019; 259527; P4-12
Sophie Ashley
Sophie Ashley
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PeIN is a rare precursor for SCC of the penis. It may be undifferentiated or differentiated. The former is associated with over-expression of P16. PeIN can be treated topically, surgically or with combinations of these. This study assesses the association between clinical outcome of topical therapies and P16 status.

Patients and Methods
Data were collected on patients diagnosed with PeIN referred to a single European Network (2012 - 2018). The following parameters were collected utilising electronic patient records: demographics, smoking status, performance status, co-morbidities, histology, P16 status (P16 + or P16-), LS status, treatment and response.


251 patients were identified with PeIN. Of these 114 pts were excluded for co-existing invasive cancer. Median age at diagnosis was 63 years (28-93 yrs). Median follow up was 17.5 months. 56 pts were P16+.
Overall P16+ patients showed significantly better DFS over P16- pts (10.4 vs 7.4 mths respectively; p<0.05).
In P16+ patients (n=56) receiving treatment with imiquimod alone or in combination with surgery, response rates were 100% versus 54% in those receiving treatments without imiquimod. This was significant (p<0.05).
Overall 13.6% of patients progressed to invasive penile carcinoma (17% P16+, 16.7% P16-).


This is the largest cohort of PeIN pts globally. The results indicate that regardless of P16 status, treatment combinations with immunotherapy tend to provide better response rates. P16+ disease responds to immunotherapy based treatments and patients with P16+ disease have a longer DFS. Furthermore, the study shows that approximately 14% of patients will progress to invasive disease.
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