The UroOnc Minute: Biomarkers for Penile Cancer, with Maarten Albersen, MD, PhD

Welcome back to The UroOnc Minute!

In this episode of The UroOnc Minute, recorded live at the 2026 European Association of Urology Annual Congress in London, host Adam B. Weiner, MD, welcomes Maarten Albersen, MD, PhD, of University Hospitals Leuven, Belgium, for a focused discussion on the evolving molecular landscape of penile cancer. Framing the conversation around a rare but impactful genitourinary malignancy, the episode highlights both the current limitations and future promise of biomarker-driven care in a space that has historically lacked personalization.

Albersen outlines the foundational biology of penile cancer, emphasizing its division into HPV-driven and inflammation-driven disease, with approximately half of cases linked to human papillomavirus. While p16 staining serves as a practical surrogate marker for HPV status and is associated with improved prognosis, he notes that treatment decisions are not yet tailored based on this distinction. Building on this, his group is working to refine molecular classification further, particularly through the addition of p53 status, to better stratify patients within HPV-negative disease. Early findings suggest that combining p16 and p53 may identify subgroups with markedly different outcomes, offering a potential pathway toward more precise, biology-informed care.

The discussion underscores the clinical urgency of this work, given the significant morbidity associated with standard penile cancer treatments, including surgery and inguinal lymph node dissection. Albersen describes emerging data from single-cell analyses that point to biologically distinct tumor microenvironments, which may have implications for biomarker-driven therapy in the future.¹ These insights raise the possibility of de-escalating treatment in favorable-risk patients while intensifying therapy for those with more aggressive disease, though he cautions that prospective validation is still needed.

Looking ahead, the conversation highlights the importance of global collaboration in advancing research for rare tumors. Ongoing efforts to build a clinically annotated European biobank and integrate translational end points into trials such as the InPACT study (NCT02305654) are expected to accelerate biomarker validation and inform future trial design. For now, Albersen advises that while molecular markers like p53 may offer early signals, their routine use in guiding clinical decisions remains premature. Still, the trajectory is clear: as molecular insights deepen, the field moves closer to a more individualized approach to penile cancer care.

REFERENCE

1. Elst L, Philips G, Vandermaesen K, et al. Single-cell Atlas of Penile Cancer Reveals TP53 Mutations as a Driver of an Aggressive Phenotype, Irrespective of Human Papillomavirus Status, and Provides Clues for Treatment Personalization. Eur Urol. 2024;86(2):114-127. doi:10.1016/j.eururo.2024.03.038