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Anal cancer: is neoadjuvant cisplatin chemotherapy or chemoradiotherapy friend or foe?

Nature Clinical Practice Oncology volume 5, pages 692–693 (2008)Cite this article

Abstract

This Practice Point commentary discusses the findings of the Intergroup RTOG 98–11 trial, which aimed to investigate both the potential role of cisplatin as neoadjuvant chemotherapy, and also its role concurrently in combination with radiotherapy, for anal-canal carcinoma. Although chemoradiotherapy has had an important effect on the treatment of anal cancer, and allows preservation of anorectal function with survival rates similar to or better than those of surgical treatment, overall survival rates for advanced tumors are still in the region of 50–60% at 5 years. A strong theoretical rationale for cisplatin-based treatment in anal cancer exists; several phase II trials have demonstrated a high response rate with reduced colostomy rates. The Intergroup results are disappointing in that neoadjuvant chemotherapy with cisplatin and 5-fluorouracil, followed by cisplatin-based chemoradiotherapy did not improve overall survival, disease-free survival and locoregional control when compared with the standard treatment of combined 5-fluorouracil and mitomycin chemoradiotherapy.

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References

  1. UKCCCR Anal Cancer Trial Working Party (1996) Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil and mitomycin. Lancet 348: 1049–1054

  2. Flam M et al. (1996) 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 14: 2527–2539

    Article  CAS  Google Scholar 

  3. Bartelink H et al. (1997) 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 15: 2040–2049

    Article  CAS  Google Scholar 

  4. Peiffert D et al. (2005) Induction chemotherapy (ICT) and dose intensification of the radiation boost in locally advanced anal cancer (LAACC): interim analysis of the 101 first randomised patients (pts) in the Intergroup ACCORD 03 trial (Federation Nacionale des Centres de Lutte Contre le Cancer—Fondation Française de Cancérologie Digestive) [abstract #614. Eur J Cancer 3 (Suppl 2): 172–173

    Google Scholar 

  5. Meropol NJ et al. (2008) Induction therapy for poor-prognosis anal canal carcinoma: a phase II study of the Cancer and Leukemia Group B (CALGB 9281). J Clin Oncol 26: 3229–3234

    Article  CAS  Google Scholar 

  6. Ajani JA et al. (2008) Fluorouracil, mitomycin and radiotherapy vs fluorouracil, cisplatin and radiotherapy for carcinoma of the anal canal: a randomised controlled trial. JAMA 199: 1914–1921

    Article  Google Scholar 

  7. James R et al. (2005) ACT II: the second UK phase III anal cancer trial. Clin Oncol 17: 364–366

    Article  CAS  Google Scholar 

  8. Glynne-Jones R and Hoskin P (2007) Neoadjuvant cisplatin chemotherapy before chemoradiation: a flawed paradigm. J Clin Oncol 25: 5281–5286

    Article  Google Scholar 

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Authors and Affiliations

  1. R Glynne-Jones is a Clinical Oncologist at Mount Vernon Cancer Centre and Watford and Barnet General Hospitals in London.,

    Robert Glynne-Jones

  2. S Mawdsley is a Consultant Clinical Oncologist at Mount Vernon Hospital, London, UK.,

    Suzannah Mawdsley

Authors
  1. Robert Glynne-Jones
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  2. Suzannah Mawdsley
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Corresponding author

Correspondence to Robert Glynne-Jones.

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Competing interests

R Glynne-Jones has received honoraria from Roche, Sanofi-Aventis, Merck Serono and Pfizer for attendance at advisory boards, speakers' bureau, and support received to attend international meetings.

S Mawdsley declared no competing interests.

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Glynne-Jones, R., Mawdsley, S. Anal cancer: is neoadjuvant cisplatin chemotherapy or chemoradiotherapy friend or foe?. Nat Rev Clin Oncol 5, 692–693 (2008). https://doi.org/10.1038/ncponc1258

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