Penile cancer is a rare genitourinary malignancy that is associated with poor outcomes and severely limited therapeutic options that are generally non-curative when used to treat localized disease with high-risk features or advanced disease. To address the unmet need for treatment modalities with increased effectiveness, immune-based therapies such as immune-checkpoint blockade, human papilloma virus (HPV)-directed vaccines and adoptive T cell therapies have emerged as potential treatment options for advanced penile cancer. A diverse array of immune cells such as cytotoxic T lymphocytes (CTLs), tumour-associated macrophages and myeloid-derived suppressor cells have been shown to infiltrate penile cancer tumours, with distinct immune landscapes being demonstrated in HPV-positive compared with HPV-negative tumours. Study results have also demonstrated the prognostic value of immune cells such as tumour-associated macrophages, immune markers such as programmed death ligand-1, and HPV-status in penile cancer. Taken together, these findings underscore the clinical relevance of the tumour immune microenvironment as a source of both prognostic indicators and potential therapeutic targets for immune-based therapies. Current evidence regarding the safety and efficacy of immune-based therapies is limited in penile cancer, but a number of clinical and preclinical studies are ongoing to evaluate these therapies in this disease based on promising results from studies in other malignancies, including other squamous cell carcinomas. In addition, an opportunity exists to combine immune-based therapies with existing lines of systemic therapy to offer the most benefit to patients with advanced penile cancer. Future work should focus on expansion of preclinical models for immune-based drug discovery.

阴茎癌是一种罕见的泌尿生殖系统恶性肿瘤，与预后不良和严重受限的治疗选择有关，当用于治疗具有高风险特征的局部疾病或晚期疾病时，这些选择通常无法治愈。为了解决对提高有效性的治疗方式的未满足需求，免疫检查点阻断、人乳头瘤病毒 (HPV) 导向疫苗和过继性 T 细胞疗法等基于免疫的疗法已成为晚期阴茎癌的潜在治疗选择。多种免疫细胞，如细胞毒性 T 淋巴细胞 (CTL)、肿瘤相关巨噬细胞和髓源性抑制细胞已被证明可以浸润阴茎癌肿瘤，与 HPV 阴性肿瘤相比，HPV 阳性肿瘤具有不同的免疫景观. 研究结果还证明了免疫细胞（如肿瘤相关巨噬细胞）、免疫标志物（如程序性死亡配体-1）和阴茎癌中 HPV 状态的预后价值。总之，这些发现强调了肿瘤免疫微环境作为预后指标和基于免疫疗法的潜在治疗靶点的临床相关性。目前关于基于免疫疗法的安全性和有效性的证据在阴茎癌中是有限的，但基于其他恶性肿瘤（包括其他鳞状细胞癌）研究的有希望的结果，许多临床和临床前研究正在进行中，以评估这些疗法在这种疾病中的疗效. 此外，有机会将基于免疫的疗法与现有的全身疗法相结合，从而为晚期阴茎癌患者提供最大的益处。未来的工作应侧重于扩展基于免疫的药物发现的临床前模型。