Skip to main content
Erschienen in: Current Oncology Reports 3/2010

01.05.2010

Current and Emerging Treatment Strategies for Anal Cancer

verfasst von: Jeffrey Meyer, Christopher Willett, Brian Czito

Erschienen in: Current Oncology Reports | Ausgabe 3/2010

Einloggen, um Zugang zu erhalten

Abstract

Concurrent radiotherapy and chemotherapy (5-fluorouracil and mitomycin-C) is established as a sphincter-preserving treatment for squamous cell carcinoma of the anal canal. However, there is room for improvement in rates of tumor control as well as a need to reduce treatment-induced toxicity. Efforts are underway to test the value of newer radiosensitizing chemotherapeutic and molecular targeted agents, as well as to establish the value of advances in radiation therapy planning and delivery. This review discusses the evolution of therapy for anal cancer, from early clinical trials establishing the current standard to more recent studies evaluating cisplatin, capecitabine, oxaliplatin, and cetuximab. Early clinical results from studies incorporating intensity-modulated radiation therapy are also discussed.
Literatur
1.
Zurück zum Zitat Forastiere AA, Goepfert H, Maor M, et al.: Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. New Engl J Med 2003, 349:2091–2098.CrossRefPubMed Forastiere AA, Goepfert H, Maor M, et al.: Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. New Engl J Med 2003, 349:2091–2098.CrossRefPubMed
2.
Zurück zum Zitat Nigro ND, Vaitkevicius VK, Considine B Jr: Combined therapy for cancer of the anal canal: a follow-up report. Dis Colon Rectum 1977, 20:677–678.CrossRefPubMed Nigro ND, Vaitkevicius VK, Considine B Jr: Combined therapy for cancer of the anal canal: a follow-up report. Dis Colon Rectum 1977, 20:677–678.CrossRefPubMed
3.
Zurück zum Zitat Boman BM, Moertel CG, O’Connell MJ, et al.: Carcinoma of the anal canal. A clinical and pathologic study of 188 cases. Cancer 1984, 54:114–125.CrossRefPubMed Boman BM, Moertel CG, O’Connell MJ, et al.: Carcinoma of the anal canal. A clinical and pathologic study of 188 cases. Cancer 1984, 54:114–125.CrossRefPubMed
4.
Zurück zum Zitat Nigro ND, Vaitkevicius VK, Considine B Jr: Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974, 17:354–356.CrossRefPubMed Nigro ND, Vaitkevicius VK, Considine B Jr: Combined therapy for cancer of the anal canal: a preliminary report. Dis Colon Rectum 1974, 17:354–356.CrossRefPubMed
5.
Zurück zum Zitat Epidermoid anal cancer: results from the UKCCCR randomized trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet 1996, 348:1049–1054. Epidermoid anal cancer: results from the UKCCCR randomized trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. UKCCCR Anal Cancer Trial Working Party. UK Co-ordinating Committee on Cancer Research. Lancet 1996, 348:1049–1054.
6.
Zurück zum Zitat Bartelink H, Roelofsen F, Eschwege F, et al.: Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 1997, 15:2040–2049.PubMed Bartelink H, Roelofsen F, Eschwege F, et al.: Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer: results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 1997, 15:2040–2049.PubMed
7.
Zurück zum Zitat Flam M, John M, Pajak T, et al.: Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol 1996, 14:2527–2539.PubMed Flam M, John M, Pajak T, et al.: Role of mitomycin in combination with fluorouracil and radiotherapy, and of salvage chemoradiation in the definitive nonsurgical treatment of epidermoid carcinoma of the anal canal: results of a phase III randomized intergroup study. J Clin Oncol 1996, 14:2527–2539.PubMed
8.
Zurück zum Zitat Ajani J, Winter K, Gunderson L, et al.: Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal. A randomized controlled trial. JAMA 2008, 299:1914–1921.CrossRefPubMed Ajani J, Winter K, Gunderson L, et al.: Fluorouracil, mitomycin, and radiotherapy vs fluorouracil, cisplatin, and radiotherapy for carcinoma of the anal canal. A randomized controlled trial. JAMA 2008, 299:1914–1921.CrossRefPubMed
9.
Zurück zum Zitat James R, Wan S, Glynne-Jones R, et al.: A randomized trial of chemoradiation using mitomycin or cisplatin, with or without maintenance cisplatin/5FU in squamous cell carcinoma of the anus (ACT II) [suppl; abstr LBA4009]. J Clin Oncol 2009, 27:18s.CrossRef James R, Wan S, Glynne-Jones R, et al.: A randomized trial of chemoradiation using mitomycin or cisplatin, with or without maintenance cisplatin/5FU in squamous cell carcinoma of the anus (ACT II) [suppl; abstr LBA4009]. J Clin Oncol 2009, 27:18s.CrossRef
10.
Zurück zum Zitat Conroy T, Ducreux M, Lemanski C, et al.: Treatment intensification by induction chemotherapy (ICT) and radiation dose escalation in locally advanced squamous cell anal carcinoma (LAAC): definitive analysis of the intergroup ACCORD 03 trial [abstract 4033]. J Clin Oncol 2009, 27(Suppl 1). Conroy T, Ducreux M, Lemanski C, et al.: Treatment intensification by induction chemotherapy (ICT) and radiation dose escalation in locally advanced squamous cell anal carcinoma (LAAC): definitive analysis of the intergroup ACCORD 03 trial [abstract 4033]. J Clin Oncol 2009, 27(Suppl 1).
11.
Zurück zum Zitat Matzinger O, Roelofsen F, Mineur L, et al.: Mitomycin C with continuous fluorouracil or with cisplatin in combination with radiotherapy for locally advanced anal cancer (European Organisation for Research and Treatment of Cancer phase II study 22011-40014). Eur J Cancer 2009, 45:2782–2791.CrossRefPubMed Matzinger O, Roelofsen F, Mineur L, et al.: Mitomycin C with continuous fluorouracil or with cisplatin in combination with radiotherapy for locally advanced anal cancer (European Organisation for Research and Treatment of Cancer phase II study 22011-40014). Eur J Cancer 2009, 45:2782–2791.CrossRefPubMed
12.
Zurück zum Zitat Miwa M, Ura M, Nishida M, et al.: Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumors by enzymes concentrated in human liver and cancer tissue. Eur J Cancer 1998, 34:1274–1281.CrossRefPubMed Miwa M, Ura M, Nishida M, et al.: Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumors by enzymes concentrated in human liver and cancer tissue. Eur J Cancer 1998, 34:1274–1281.CrossRefPubMed
13.
Zurück zum Zitat Glynne-Jones R, Meadows H, Wan S, et al.: 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, 72:119–126.PubMed Glynne-Jones R, Meadows H, Wan S, et al.: 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, 72:119–126.PubMed
14.
Zurück zum Zitat Folkvord S, Flatmark K, Seierstad T, et al.: Inhibitory effects of oxaliplatin in experimental radiation treatment of colorectal carcinoma: does oxaliplatin improve 5-fluorouracil-dependent radiosensitivity? Radiother Oncol 2008, 86:428–434.CrossRefPubMed Folkvord S, Flatmark K, Seierstad T, et al.: Inhibitory effects of oxaliplatin in experimental radiation treatment of colorectal carcinoma: does oxaliplatin improve 5-fluorouracil-dependent radiosensitivity? Radiother Oncol 2008, 86:428–434.CrossRefPubMed
15.
Zurück zum Zitat Sawada N, Kondoh K, Mori K: Enhancement of capecitabine efficacy by oxaliplatin in human colorectal and gastric cancer xenografts. Oncol Rep 2007, 18:775–778.PubMed Sawada N, Kondoh K, Mori K: Enhancement of capecitabine efficacy by oxaliplatin in human colorectal and gastric cancer xenografts. Oncol Rep 2007, 18:775–778.PubMed
16.
Zurück zum Zitat Eng C, Chang GJ, Das P, et al.: Phase II study of capecitabine and oxaliplatin with concurrent radiation therapy (XELOX-XRT) for squamous cell carcinoma of the anal canal [abstr 4116]. J Clin Oncol 2009, 27(Suppl):15s. Eng C, Chang GJ, Das P, et al.: Phase II study of capecitabine and oxaliplatin with concurrent radiation therapy (XELOX-XRT) for squamous cell carcinoma of the anal canal [abstr 4116]. J Clin Oncol 2009, 27(Suppl):15s.
17.
Zurück zum Zitat Chen DJ, Nirodi CS: The epidermal growth factor: a role in repair of radiation-induced DNA damage. Clin Cancer Res 2007, 12:6555–6560.CrossRef Chen DJ, Nirodi CS: The epidermal growth factor: a role in repair of radiation-induced DNA damage. Clin Cancer Res 2007, 12:6555–6560.CrossRef
18.
Zurück zum Zitat Milas L, Mason K, Hunter N, et al.: In vivo enhancement of tumor radioresponse by C225 antiepidermal growth factor receptor antibody. Clin Cancer Res 2000, 6:701–707.PubMed Milas L, Mason K, Hunter N, et al.: In vivo enhancement of tumor radioresponse by C225 antiepidermal growth factor receptor antibody. Clin Cancer Res 2000, 6:701–707.PubMed
19.
Zurück zum Zitat Bonner JA, Harari PM, Giralt J, et al.: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 2010, 11:21–28.CrossRefPubMed Bonner JA, Harari PM, Giralt J, et al.: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 2010, 11:21–28.CrossRefPubMed
20.
Zurück zum Zitat Karapetis CS, Khambata-Ford S, Jonker DJ, et al.: K-ras mutations and benefit from cetuximab in advanced colorectal cancer. New Engl J Med 2008, 359:1757–1765.CrossRefPubMed Karapetis CS, Khambata-Ford S, Jonker DJ, et al.: K-ras mutations and benefit from cetuximab in advanced colorectal cancer. New Engl J Med 2008, 359:1757–1765.CrossRefPubMed
21.•
Zurück zum Zitat Zampino MG, Magni E, Sonzogni A, et al.: K-ras status in squamous cell anal carcinoma (SCC): it’s time for target-oriented treatment? Cancer Chemother Pharmacol 2009, 65:197–199. There is a lack of data regarding molecular predictors of response to targeted drug therapy for anal cancer. This report is one of the first to evaluate K-ras status for this disease.CrossRefPubMed Zampino MG, Magni E, Sonzogni A, et al.: K-ras status in squamous cell anal carcinoma (SCC): it’s time for target-oriented treatment? Cancer Chemother Pharmacol 2009, 65:197–199. There is a lack of data regarding molecular predictors of response to targeted drug therapy for anal cancer. This report is one of the first to evaluate K-ras status for this disease.CrossRefPubMed
22.
Zurück zum Zitat Olivatto LO, Meton F, Bezerra M, et al.: Phase I study of cetuximab (CET) in combination with 5-fluorouracil (5-FU), cisplatin (CP), and radiotherapy (RT) in patients with locally advanced squamous cell anal carcinoma (LAAC) [abstr 4609]. J Clin Oncol 2008, 26(Suppl). Olivatto LO, Meton F, Bezerra M, et al.: Phase I study of cetuximab (CET) in combination with 5-fluorouracil (5-FU), cisplatin (CP), and radiotherapy (RT) in patients with locally advanced squamous cell anal carcinoma (LAAC) [abstr 4609]. J Clin Oncol 2008, 26(Suppl).
23.
Zurück zum Zitat Abrams RA, Winter KA, Regine WF, et al.: Correlation of RTOG 9704 (adjuvant therapy (rx) of pancreatic adenocarcinoma (pan ca)) radiation therapy quality assurance scores (RTQASc) with survival (S) [abstr 4523]. J Clin Oncol 2007, 25(Suppl). Abrams RA, Winter KA, Regine WF, et al.: Correlation of RTOG 9704 (adjuvant therapy (rx) of pancreatic adenocarcinoma (pan ca)) radiation therapy quality assurance scores (RTQASc) with survival (S) [abstr 4523]. J Clin Oncol 2007, 25(Suppl).
24.•
Zurück zum Zitat Myerson RJ, Garofalo MC, El Naqa I, et al.: Elective clinical target volumes for conformal therapy in anorectal cancer: a Radiation Therapy Oncology Group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys 2009, 74:824–830. This consensus report from the RTOG helps standardize anal cancer clinical treatment volumes.PubMed Myerson RJ, Garofalo MC, El Naqa I, et al.: Elective clinical target volumes for conformal therapy in anorectal cancer: a Radiation Therapy Oncology Group consensus panel contouring atlas. Int J Radiat Oncol Biol Phys 2009, 74:824–830. This consensus report from the RTOG helps standardize anal cancer clinical treatment volumes.PubMed
25.
Zurück zum Zitat Salama JK, Mell L, Schomas DA, et al.: Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience. J Clin Oncol 2007, 25:4581–4586.CrossRefPubMed Salama JK, Mell L, Schomas DA, et al.: Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience. J Clin Oncol 2007, 25:4581–4586.CrossRefPubMed
26.
Zurück zum Zitat Pepek JM, Willett CG, Clough RW, et al.: Intensity modulated radiation therapy (IMRT) for anal cancer: The Duke University experience. Int J Radiat Oncol Biol Phys 2009, 75(Suppl):S267. Pepek JM, Willett CG, Clough RW, et al.: Intensity modulated radiation therapy (IMRT) for anal cancer: The Duke University experience. Int J Radiat Oncol Biol Phys 2009, 75(Suppl):S267.
27.•
Zurück zum Zitat Kachnic L, Winter K, Myerson R, et al.: RTOG 0529: A phase II evaluation of dose-painted IMRT in combination with 5-fluorouracil and mitomycin-C for reduction of acute morbidity in carcinoma of the anal canal. Int J Radiat Oncol Biol Phys 2009, 75(Suppl):S5. This is the first report of the RTOG clinical study evaluating the value of IMRT in reducing treatment toxicity. Kachnic L, Winter K, Myerson R, et al.: RTOG 0529: A phase II evaluation of dose-painted IMRT in combination with 5-fluorouracil and mitomycin-C for reduction of acute morbidity in carcinoma of the anal canal. Int J Radiat Oncol Biol Phys 2009, 75(Suppl):S5. This is the first report of the RTOG clinical study evaluating the value of IMRT in reducing treatment toxicity.
28.
Zurück zum Zitat Hoffman R, Welton ML, Klencke B, et al.: The significance of pretreatment CD4 count on the outcome and treatment tolerance of HIV-positive patients with anal cancer. Int J Radiat Oncol Biol Phys 1999, 44:127–131.CrossRefPubMed Hoffman R, Welton ML, Klencke B, et al.: The significance of pretreatment CD4 count on the outcome and treatment tolerance of HIV-positive patients with anal cancer. Int J Radiat Oncol Biol Phys 1999, 44:127–131.CrossRefPubMed
29.
Zurück zum Zitat Seo Y, Kinsella MT, Reynolds HL, et al.: Outcomes of chemoradiotherapy with 5-flurorouracil and mitomycin C for anal cancer in immunocompetent versus immunodeficient patients. Int J Radiat Oncol Biol Phys 2009, 75:143–149.PubMed Seo Y, Kinsella MT, Reynolds HL, et al.: Outcomes of chemoradiotherapy with 5-flurorouracil and mitomycin C for anal cancer in immunocompetent versus immunodeficient patients. Int J Radiat Oncol Biol Phys 2009, 75:143–149.PubMed
30.•
Zurück zum Zitat Chiao EY, Giorfano TP, Richardson P, et al.: Human immunodeficiency virus-associated squamous cell cancer of the anus: epidemiology and outcomes in the highly active antiretroviral therapy era. J Clin Oncol 2008, 26:474–479.CrossRefPubMed Chiao EY, Giorfano TP, Richardson P, et al.: Human immunodeficiency virus-associated squamous cell cancer of the anus: epidemiology and outcomes in the highly active antiretroviral therapy era. J Clin Oncol 2008, 26:474–479.CrossRefPubMed
Metadaten
Titel
Current and Emerging Treatment Strategies for Anal Cancer
verfasst von
Jeffrey Meyer
Christopher Willett
Brian Czito
Publikationsdatum
01.05.2010
Verlag
Current Science Inc.
Erschienen in
Current Oncology Reports / Ausgabe 3/2010
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-010-0100-9

Weitere Artikel der Ausgabe 3/2010

Current Oncology Reports 3/2010 Zur Ausgabe

Labor, CT-Anthropometrie zeigen Risiko für Pankreaskrebs

13.05.2024 Pankreaskarzinom Nachrichten

Gerade bei aggressiven Malignomen wie dem duktalen Adenokarzinom des Pankreas könnte Früherkennung die Therapiechancen verbessern. Noch jedoch klafft hier eine Lücke. Ein Studienteam hat einen Weg gesucht, sie zu schließen.

Viel pflanzliche Nahrung, seltener Prostata-Ca.-Progression

12.05.2024 Prostatakarzinom Nachrichten

Ein hoher Anteil pflanzlicher Nahrung trägt möglicherweise dazu bei, das Progressionsrisiko von Männern mit Prostatakarzinomen zu senken. In einer US-Studie war das Risiko bei ausgeprägter pflanzlicher Ernährung in etwa halbiert.

Alter verschlechtert Prognose bei Endometriumkarzinom

11.05.2024 Endometriumkarzinom Nachrichten

Ein höheres Alter bei der Diagnose eines Endometriumkarzinoms ist mit aggressiveren Tumorcharakteristika assoziiert, scheint aber auch unabhängig von bekannten Risikofaktoren die Prognose der Erkrankung zu verschlimmern.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.