Anal cancer
Revision as of 14:16, 6 January 2019 by Jwarner (talk | contribs) (→Chemotherapy for metastatic disease)
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| coming soon | Ari Seifter, MD University of Illinois at Chicago Chicago, IL |
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Neeta K. Venepalli, MD, MBA University of Illinois at Chicago Chicago, IL |
9 regimens on this page
13 variants on this page
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Guidelines
ESMO
- Anal cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up PubMed
NCCN
Definitive chemoradiotherapy for locally advanced disease
Capecitabine, Mitomycin, RT
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Regimen
| Study | Evidence |
|---|---|
| Glynne-Jones et al. 2008 | Phase II |
Chemoradiotherapy
- Capecitabine (Xeloda) 825 mg/m2 PO BID on radiation days
- Mitomycin (Mutamycin) 12 mg/m2 IV once on day 1
- Concurrent radiation therapy: 1.8 Gy per day x 28 fractions (total dose: 50.4 Gy)
6-week course
References
- EXTRA: Glynne-Jones R, Meadows H, Wan S, Gollins S, Leslie M, Levine E, McDonald AC, Myint S, Samuel L, Sebag-Montefiore D; National Cancer Research Institute Anal Sub Group and Colorectal Clinical Oncology Group. EXTRA--a multicenter phase II study of chemoradiation using a 5 day per week oral regimen of capecitabine and intravenous mitomycin C in anal cancer. Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):119-26. Epub 2008 May 9. link to original article contains protocol PubMed
Cisplatin, Fluorouracil, RT
Fluorouracil, cisplatin, radiation therapy for anal cancer
Fluorouracil, Mitomycin, RT
Fluorouracil, mitomycin, radiation therapy for anal cancer
Radiation therapy
Radiation therapy for anal cancer
Metastatic disease, first-line therapy
Cisplatin & Fluorouracil
Fluorouracil & cisplatin for anal cancer
mDCF
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mDCF: modified Docetaxel, Cisplatin, Fluorouracil
Regimen
| Study | Evidence |
|---|---|
| Kim et al. 2018 (Epitopes-HPV02) | Phase II |
Chemotherapy
- Docetaxel (Taxotere) 40 mg/m2 IV once on day 1
- Cisplatin (Platinol) 40 mg/m2 IV once on day 1
- Fluorouracil (5-FU) 1200 mg/m2/day IV continuous infusion over 48 hours, started on day 1 (total dose per cycle: 2400 mg/m2)
14-day cycle for 8 cycles
References
- Epitopes-HPV02: Kim S, François E, André T, Samalin E, Jary M, El Hajbi F, Baba-Hamed N, Pernot S, Kaminsky MC, Bouché O, Desrame J, Zoubir M, Ghiringhelli F, Parzy A, De La Fouchardiere C, Smith D, Deberne M, Spehner L, Badet N, Adotevi O, Anota A, Meurisse A, Vernerey D, Taieb J, Vendrely V, Buecher B, Borg C. Docetaxel, cisplatin, and fluorouracil chemotherapy for metastatic or unresectable locally recurrent anal squamous cell carcinoma (Epitopes-HPV02): a multicentre, single-arm, phase 2 study. Lancet Oncol. 2018 Aug;19(8):1094-1106. Epub 2018 Jul 2. link to original article PubMed
Metastatic disease, subsequent lines of therapy
Nivolumab monotherapy
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Regimen
| Study | Evidence |
|---|---|
| Morris et al. 2017 (NCI9673) | Phase II |
Immunotherapy
- Nivolumab (Opdivo) 3 mg/kg IV once on day 1
14-day cycles
References
- NCI9673: Morris VK, Salem ME, Nimeiri H, Iqbal S, Singh P, Ciombor K, Polite B, Deming D, Chan E, Wade JL, Xiao L, Bekaii-Saab T, Vence L, Blando J, Mahvash A, Foo WC, Ohaji C, Pasia M, Bland G, Ohinata A, Rogers J, Mehdizadeh A, Banks K, Lanman R, Wolff RA, Streicher H, Allison J, Sharma P, Eng C. Nivolumab for previously treated unresectable metastatic anal cancer (NCI9673): a multicentre, single-arm, phase 2 study. Lancet Oncol. 2017 Apr;18(4):446-453. Epub 2017 Feb 18. link to original article link to PMC article PubMed