Immunotherapy can extend life of people with rare form of cancer, study finds

Men with a rare form of cancer could live longer than currently expected, following a clinical trial by University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) and funded by Regeneron.

The EPIC study looked at patients with advanced penile cancer, from 11 hospitals across England and Scotland, and offered them a medicine which can harness their own immune system to help them fight the disease.

Using immunotherapy to fight cancer is still considered a relatively new treatment. Although not all cancer patients see the benefit, this study saw more than half the participants had their predicted lifespan extended when they had immunotherapy alongside chemotherapy.

Every patient recruited on to the study had advanced penile cancer and was unable to have further treatment to cure their cancer.

While not able to cure the patient’s cancer, due to its late stages, more than 60 per cent of patients who received treatment had clinical benefit from being on the study. This was reflected in improved patient survival which increased to 15 months on average compared to less than a year reported in other studies for patients whose penile cancer was at a similar stage.

Eddie Baker, 83, from Yate was the first patient recruited on to the EPIC trial. He finished his treatment in September 2023.

“When I was first approached about the trial I thought why not? If there’s a chance it will help me and maybe help someone else in the future, then I am all for it.

"The doctors and the nurses have seen me right; I cannot fault them. I was able to carry on as normal after each of my treatments.

"If someone else was offered the chance to take part in a trial I would recommend it. If there is a chance to help someone else, then you’ve got to go for it.”

Professor Amit Bahl, UHBW consultant oncologist and chief investigator of the EPIC study said: “Often when patients present with metastatic disease, or locally advanced cancer, the potential to tolerate treatment with chemotherapy may be limited and response rates with chemotherapy are modest. With addition of immunotherapy our aim is to improve outcomes in this rare cancer which has limited treatment options.

"The immunotherapy means we are activating the body’s own immune system, and tolerance to immunotherapy generally is better than the tolerance to chemotherapy.”

When cancer cells are present in the body they can divide very quickly. Usually, our bodies are good at spotting cells which are not supposed to be there, but cancer is able to disguise itself so our immune systems cannot find it.

Immunotherapy drugs block the proteins on the surface of cancer cells which allow them to go undetected and help the immune system to see the cancer cells and start battling the cancer.

Chemotherapy targets all rapidly dividing cells, not just cancer cells, which means it can cause hair loss and affect the lining of the gut among other severe side effects. Immunotherapy still has side effects, as the immune system can react in other ways, but generally they are more manageable.

Penile cancer is rare, and it usually presents externally first, so when patients are diagnosed early treatments which can cure the cancer are possible. But like with all cancers, patients sometimes miss early symptoms, or are not suited to chemotherapy, radiotherapy, or surgery.

Penile cancer can be a very aggressive disease, but this study shows we might be able to give men a little more time.”

Penile cancer is a rare cancer, most common in men over 50. Like all cancers it is more treatable if found early.

Most Common Symptoms:

• A growth, lump or sore that does not heal within 4 weeks
• A rash
• Bleeding from your penis or under your foreskin
• A smelly discharge
• Difficulty pulling back your foreskin
• A change in the colour of the skin of your penis or foreskin

Other Possible Symptoms:

• A lump in your groin
• Feeling tired
• Tummy pain
• Losing weight without trying