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Background and Current Treatment of Squamous Cell Carcinoma of the Anus

Background and Current Treatment of Squamous Cell Carcinoma of the Anus In this review, a summary of our current understanding of squamous cell carcinoma of the anus (SCCA) and the advances in our knowledge of SCCA regarding screening, prevention, the role of the immune system, current treatment and the potential for novel targets are discussed. The present standard of care in terms of treatment is 5-fluorouracil (5-FU) and mitomycin C (MMC) concurrently with radiation, which results in a high level of disease control for small early cancers. Preservation of the anal sphincter is achieved in the majority, although anorectal function is often impaired. Although evidence from prospective studies to support a change in the treatment strategy is lacking, patients with HPV-negative SCCA appear to be less responsive to chemoradiation (CRT) and relapse more frequently. In contrast, HPV-positive tumours usually fare better, but oncological outcomes are modified by smoking and immune incompetence. There is current interest in escalating the radiotherapy dose for larger, more advanced tumours, and de-escalating treatment for HPV-positive tumours. The use of novel immunological treatments to target the underlying different molecular pathways of HPV-positive cancers is exciting. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Oncology and Therapy Springer Journals

Background and Current Treatment of Squamous Cell Carcinoma of the Anus

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Publisher
Springer Journals
Copyright
Copyright © 2016 by The Author(s)
Subject
Medicine & Public Health; Internal Medicine
ISSN
2366-1070
eISSN
2366-1089
DOI
10.1007/s40487-016-0024-0
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Abstract

In this review, a summary of our current understanding of squamous cell carcinoma of the anus (SCCA) and the advances in our knowledge of SCCA regarding screening, prevention, the role of the immune system, current treatment and the potential for novel targets are discussed. The present standard of care in terms of treatment is 5-fluorouracil (5-FU) and mitomycin C (MMC) concurrently with radiation, which results in a high level of disease control for small early cancers. Preservation of the anal sphincter is achieved in the majority, although anorectal function is often impaired. Although evidence from prospective studies to support a change in the treatment strategy is lacking, patients with HPV-negative SCCA appear to be less responsive to chemoradiation (CRT) and relapse more frequently. In contrast, HPV-positive tumours usually fare better, but oncological outcomes are modified by smoking and immune incompetence. There is current interest in escalating the radiotherapy dose for larger, more advanced tumours, and de-escalating treatment for HPV-positive tumours. The use of novel immunological treatments to target the underlying different molecular pathways of HPV-positive cancers is exciting.

Journal

Oncology and Therapy – Springer Journals

Published: Aug 1, 2016

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    Correa, JHS; Castro, LS; Kesley, R; Dias, JA; Olivatto, LO; Martins, IO; Lopasso, FP
  • Outcome of salvage surgery for anal squamous cell carcinoma
    Harris, DA; Williamson, J; Davies, M; Evans, MD; Drew, P; Beynon, J
  • Anal canal cancer treatment: practical limitations of routine prescription of concurrent chemotherapy and radiotherapy
    Chauveinc, L; Buthaud, X; Falcou, MC; Mosseri, V; Rochefordiere, A; Pierga, JY; Girodet, J; Salmon, RJ
  • Impact of clinical and therapeutic factors on major late complications after radiotherapy with or without concomitant chemotherapy for anal carcinoma
    Allal, AS; Mermillod, B; Roth, AD; Marti, MC; Kurtz, JM
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    Benton, B; Norton, C; Linday, JO
  • Radiochemotherapy of locally advanced anal canal carcinoma: prospective assessment of early impact on the quality of life (randomized trial ACCORD 03)
    Tournier-Rangeard, L; Mercier, M; Peiffert, D; Gerard, JP; Romestaing, P; Lemanski, C; Mirabel, X; Pommier, P; Denis, B
  • Late effects and quality of life after chemo-radiation for the treatment of anal cancer
    Knowles, G; Haigh, R; McLean, C; Phillips, H
  • Curative intent radiation therapy in anal carcinoma: quality of life and sphincter control
    Vordermark, D; Sailer, M; Flentje, M
  • Impaired sphincter function and good quality of life in anal carcinoma patients after radiotherapy: a paradox?
    Vordermark, D; Sailer, M; Flentje, M; Thiede, A; Kolbl, O
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    Sodergren, SC; Vassiliou, V; Dennis, K; Tomaszewski, KA; Gilbert, A; Glynne-Jones, R; Nugent, K; Sebag-Montefiore, D; Johnson, CD
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    Lépinoy, A; Lescut, N; Puyraveau, M; Caubet, M; Boustani, J; Lakkis, Z
  • Normal tissue tolerance to external beam radiation therapy: anal canal
    Moreau-Claeys, MV; Peiffert, D
  • Concurrent chemotherapy and intensity-modulated radiation therapy for anal canal cancer patients: a multicenter experience
    Salama, JK; Mell, LK; Schomas, DA; Miller, RC; Devisetty, K; Jani, AB; Mundt, AJ; Roeske, JC; Liauw, SL; Chmura, SJ
  • Association between bone marrow dosimetric parameters and acute hematologic toxicity in anal cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy
    Mell, LK; Schomas, DA; Salama, JK; Devisetty, K; Aydogan, B; Miller, RC; Jani, AB; Kindler, HL; Mundt, AJ; Roeske, JC; Chmura, SJ
  • Expression of epidermal growth factor receptor in squamous cell carcinomas of the anal canal is independent of gene amplification
    Alvarez, G; Perry, A; Tan, BR; Wang, HL
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    Damme, N; Deron, P; Roy, N; Demetter, P; Bols, A; Dorpe, J; Baert, F; Laethem, JL; Speleman, F; Pauwels, P; Peeters, M
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