Chemoradiation is the standard-of-care for anal cancer but, as not all patients respond to mitomycin, should mitomycin be replaced with cisplatin? In an open-label trial of 940 patients with squamous-cell carcinoma of the anus, mitomycin or cisplatin with fluorouracil and radiotherapy were both equally effective (∼90% of patients had a complete response at 26 weeks). Similar levels of adverse events were reported after the two treatments. Maintenance chemotherapy gave no additional survival benefit.