{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:07:51Z","timestamp":1771286871764,"version":"3.50.1"},"reference-count":65,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das Peniskarzinom ist ein seltener, meist aus Plattenepithel hervorgehender Tumor mit teils aggressivem Verlauf. Die WHO-Klassifikation 2022 unterscheidet HPV-assoziierte (HPV(+)) von HPV-unabh\u00e4ngigen (HPV(\u2212)) Subtypen, was prognostisch und therapeutisch relevant ist. HPV(-) entstehen meist auf dem Boden einer chronischen Entz\u00fcndung, zB bei Lichen sclerosus. W\u00e4hrend HPV(+) Tumoren wie der warzige Typ eher indolent verlaufen, zeigen andere histologische Subtypen wie das basaloide oder sarkomatoide Karzinom eine ung\u00fcnstiges Prognose mit erh\u00f6hter Metastasierungsrate.<\/jats:p>\n                  <jats:p>Der alleinige HPV-Status zeigt in Studien eine uneinheitliche prognostische Aussagekraft. Dagegen ist eine p16-\u00dcberexpression als Surrogatmarker einer HPV-Positivit\u00e4t mit verbessertem \u00dcberleben assoziiert. Als kombinierter Marker empfiehlt sich die Analyse von HPV und p16, insbesondere zur Therapieentscheidung. Bei HPV(\u2212) Tumoren ist erg\u00e4nzend eine p53-Analyse sinnvoll, da hier h\u00e4ufiger TP53-Mutationen vorliegen, die mit aggressiverer Tumorbiologie einhergehen.<\/jats:p>\n                  <jats:p>Neben konventioneller Chemotherapie r\u00fccken zielgerichtete Therapien in den Fokus. Antik\u00f6rper-Drug-Konjugate (ADCs) wie Enfortumab-Vedotin (Zielantigen Nectin-4) und Sacituzumab-Govitecan (Zielantigen Trop-2) zeigen vielversprechende Ergebnisse in anderen Entit\u00e4ten. Beide Zielstrukturen werden auch beim Peniskarzinom exprimiert. Erste Studien zur Wirksamkeit werden aktuell durchgef\u00fchrt. Auch Her-2 ist in einem relevanten Anteil exprimiert und k\u00f6nnte therapeutisch nutzbar sein.<\/jats:p>\n                  <jats:p>Immuncheckpoint-Inhibitoren wie Atezolizumab zeigten bislang nur begrenzte Wirksamkeit, trotz hoher PD-L1-Expressionsraten. Ein Grund daf\u00fcr ist vermutlich das immunsuppressive Tumormikromilieu. Auch EGFR-Antik\u00f6rpertherapien stellen eine potenzielle Option dar.<\/jats:p>\n                  <jats:p>Die pr\u00e4zise histologische und molekulare Charakterisierung des Peniskarzinoms ist essenziell f\u00fcr eine individualisierte Therapie und sollte k\u00fcnftig integraler Bestandteil der klinischen Praxis sein.<\/jats:p>","DOI":"10.1055\/a-2638-4574","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T23:26:01Z","timestamp":1753399561000},"page":"28-37","source":"Crossref","is-referenced-by-count":0,"title":["Peniskarzinom: Die Bedeutung der histologischen Klassifikation und neue Behandlungsans\u00e4tze"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0633-1728","authenticated-orcid":false,"given":"August","family":"Fiegl","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Pathologie, Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan Niklas","family":"Mink","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Urologie und Kinderurologie, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0873-8128","authenticated-orcid":false,"given":"Kerstin","family":"Junker","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie und Kinderurologie, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Linxweiler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie und Kinderurologie, Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes, Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arndt","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Universit\u00e4tsklinikum Erlangen, Erlangen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s00345-008-0302-z","article-title":"Penile cancer: Epidemiology, pathogenesis and prevention","volume":"27","author":"MC Bleeker","year":"2009","journal-title":"World J Urol"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.2196\/34874","article-title":"Global pattern and trends in penile cancer incidence: Population-based study","volume":"8","author":"L Fu","year":"2022","journal-title":"JMIR Public Health Surveill"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"4748","DOI":"10.3390\/cancers15194748","article-title":"Evaluation of prognostic parameters to identify aggressive penile carcinomas","volume":"15","author":"JN Mink","year":"2023","journal-title":"Cancers Basel"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/mou.0000000000000712","article-title":"Risk factors and molecular characterization of penile cancer: Impact on prognosis and potential targets for systemic therapy","volume":"30","author":"A Thomas","year":"2020","journal-title":"Curr Opin Urol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.eururo.2016.02.029","article-title":"The 2016 who classification of tumours of the urinary system and male genital organs-part a: Renal, penile, and testicular tumours","volume":"70","author":"H Moch","year":"2016","journal-title":"Eur Urol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.eururo.2022.07.002","article-title":"The 2022 world health organization classification of tumors of the urinary system and male genital organs-part b: Prostate and urinary tract tumors","volume":"82","author":"GJ Netto","year":"2022","journal-title":"Eur Urol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1053\/j.semdp.2014.12.017","article-title":"Pathological factors, behavior, and histological prognostic risk groups in subtypes of penile squamous cell carcinomas (scc)","volume":"32","author":"DF Sanchez","year":"2015","journal-title":"Semin Diagn Pathol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1038\/modpathol.2010.69","article-title":"Warty-basaloid carcinoma: Clinicopathological features of a distinctive penile neoplasm. 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