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- Title
Recent Advances in the Management of Anal Cancer.
- Authors
Upadhyay, Laxmi; Hartzell, Michelle; Parikh, Aparna R.; Strickland, Matthew R.; Klempner, Samuel; Malla, Midhun
- Abstract
The incidence and mortality of squamous cell carcinoma of the anus (SCCA) is on the rise, which highlights the unmet need for advances in treatment options. The landscape of treatment for this cancer is rapidly evolving with novel combination strategies including immunotherapy, radiation therapy and biomarker-guided therapy. This review article features an overview of recent advancements in both locoregional and metastatic SCCA. The recent focus on locoregional SCCA management is to tailor treatment according to tumor burden and minimize treatment-related toxicities. Mitomycin plus either infusional 5-fluorouracil (5-FU) or capecitabine is used for first-line chemoradiotherapy (CRT), and intensity-modulated radiotherapy (IMRT) is the preferred modality for radiation for locoregional anal cancer. Locally recurrent disease is managed with surgical resection. Systemic treatment is first-line for metastatic SCCA and immunotherapy with nivolumab and pembrolizumab being included as second-line agents. Current and future clinical trials are evaluating treatments for SCCA including immunotherapy alone or in combination regimens, radiotherapies, targeted treatments and novel agents. Another critical aspect of current research in SCCA is the personalization of CRT and immunotherapies based on molecular characterization and biomarkers such as the programmed death-ligand 1 (PD-L1), epidermal growth factor receptor (EGFR) and circulating tumor DNA.
- Subjects
THERAPEUTIC use of antimetabolites; THERAPEUTIC use of monoclonal antibodies; PAPILLOMAVIRUSES; MITOMYCINS; PROGRAMMED death-ligand 1; IMMUNE checkpoint inhibitors; EPIDERMAL growth factor receptors; METASTASIS; CANCER relapse; ANAL tumors; FLUOROURACIL; CHEMORADIOTHERAPY; LYMPHOCYTES; RADIATION doses; TUMOR markers; RADIOTHERAPY; EXTRACELLULAR space; COMBINED modality therapy; PROGRESSION-free survival; IMMUNOTHERAPY; MEDICAL needs assessment; NUCLEIC acids; OVERALL survival
- Publication
Healthcare (2227-9032), 2023, Vol 11, Issue 23, p3010
- ISSN
2227-9032
- Publication type
Article
- DOI
10.3390/healthcare11233010