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Systemic treatments for penile squamous cell carcinoma (pSCC) are toxic and inefficient. Patient-based preclinical models are essential to study novel treatments.To establish a library of patient-derived tumor xenograft (PDX) models of human papillomavirus-positive (HPVEighteen tumor samples from 14 patients with recurrent or metastatic pSCC were implanted in nude mice. A biobank of PDX tumors was established after passaging of patient samples (F0) for three generations (F1, F2, F3) and was characterized using histopathology and targeted next-generation sequencing (tNGS). Single-nucleotide polymorphism fingerprinting was used to confirm PDX genealogy.The engraftment rate, overall growth rate, and pSCC histomorphology were checked for each PDX generation. Staining for p40 (a pSCC marker) and p16 (a surrogate for HPV infection) was performed for F0 samples. The mutational profile according to a validated panel of 96 cancer genes was determined for F0 and F3 samples and compared to a larger tNGS database.Including a previously established pilot model, 11 out of 18 tumor samples (61%) successfully engrafted in F1. The mean time from implantation in F1 to completion of F3 was 36 wk (standard deviation 18). Histological fidelity was demonstrated across generations. The patient mutational profiles were preserved in F3 and were representative of 277 pSCC samples in the Foundation Medicine database. The rapid progression of pSCC in patients from our selected high-risk cohort impeded the use of PDXs as avatars.We successfully established the first library of 11 PDX models of HPVWe established 11 animal models based on tumor tissue from patients with penile cancer. These models could play a vital role in selection of novel treatments according to genetic mutations. In the future, therapies with confirmed preclinical effects may have a profound impact on the development of personalized treatments in penile cancer.

BACKGROUND Patients with disabilities represent a unique minority population. The incidence of prostate-specific antigen (PSA) testing among this population is unknown. OBJECTIVE To compare PSA testing rates and associated predictors among men with and without reported disabilities in the USA. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of the Health Information National Trends Survey (HINTS) for the years 2012, 2013, 2017 and 2019 was conducted in men with reported disabilities. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Baseline demographics of the entire cohort were stratified based on their reported disabilities (none, disabled, deaf, and blind). Each disability was compared separately and in combination with the cohort without disabilities. Multivariable logistic regression models determined clinically significant predictors of PSA testing in men with disabilities compared with those without. RESULTS AND LIMITATIONS Overall, 782 (15%) men with disabilities were compared with 4569 (85%) men without disabilities. The former cohort was older with a median (interquartile range) age of 65 (56-75) versus 57 (43-67) yr (p < 0.001). On multivariable analysis, men with any disability were less likely to undergo PSA testing (odds ratio 0.77, 95% confidence interval 0.62-0.96, p = 0.018). Variables associated with increased PSA testing included age, having a health care provider, health insurance, and living with a partner. CONCLUSIONS Inequalities in PSA testing exist among men with disabilities in the USA, especially among the deaf and blind, being less likely to undergo PSA testing. Further research is required to identify and deal with any obstacles in the implementation of equal PSA testing in this unique population. PATIENT SUMMARY In the USA, men with reported disabilities are less likely to undergo PSA testing than patients without reported disabilities.

Background Metastatic testicular sex cord stromal tumors of the testis (MSCSTs) comprise an extremely uncommon form of genitourinary malignancy. Objective To perform comprehensive genomic profiling (CGP) to enable the search for potential therapy targets. Design, setting, and participants Ten patients with testicular Leydig cell tumors (LCTs), six with Sertoli cell tumors (SCTs), and three with undifferentiated sex cord stromal tumors (USCSTs) and a comparison group of 366 patients with ovarian sex cord stromal tumors (SCSTs) underwent hybrid-capture–based CGP to evaluate all classes of genomic alterations (GAs). The tumor mutational burden (TMB) was determined on 1.1 Mbp of sequenced DNA, and microsatellite instability (MSI) was determined on 114 loci. Intervention CGP on tumor samples. Outcome measurements and statistical analysis Descriptive analyses and differences between histological subgroups were reported. Results and limitations In these patients, all of whom had metastatic disease at the time of sequencing, the primary testis tumor was sequenced in six (32%) patients and a metastatic site in 13 (68%) patients. The overall frequencies of GAs were similar in LCTs, SCTs, and USCSTs, ranging from 3.0 to 3.5 GAs/tumor. The most frequent untargetable GAs included CTNNB1 and CDKN2A/B, both ranging from 20% to 33% of cases. Targetable GAs were uncommon in all MSCST subgroups, but several tumors showed potential for cell-cycle inhibitors (CDK4 in LCTs), mTOR inhibitors (RICTOR, NF2, and PTEN in all three tumor types), hedgehog inhibitors (PTCH1 in LCTs), and poly(ADP-ribose) polymerase inhibitors (BAP1 in SCTs). No MSI-high status was identified. The TMB was also low in all MSCST groups, and tumors featuring a TMB of ≥10 mutations/Mb were not identified. GA findings from ovarian SCSTs largely recapitulated those from MSCSTs. A lack of clinical outcome correlation is a limitation of the present analyses. Conclusions Rare cases of testicular MSCSTs have GAs linked to potential targeted therapy benefits on CGP. In contrast, the lack of MSI-high status and an overall low TMB indicate a likely lack of benefit for immunotherapies. Patient summary Genomic profiling can guide clinical research and disclose therapeutic opportunities for patients with rare testicular cancers for which standard therapies are lacking.