Anal Cancer

Cisplatin and Xeloda for metastatic anal cancer – pro

Systemic chemotherapy remains the mainstay of treatment for patient with metastatic anal cancer. The National Comprehensive Cancer Network (NCCN) Guidelines currently recommend cisplatin and 5FU chemotherapy as first-line treatment of metastatic squamous cell carcinoma (SCC). This is largely based on a study of 19 patients treated with cisplatin 100 mg/m2 and infusional 5FU 1 gm/m2/day over 5 days with a 66% response rate; there was 1 complete

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Adjuvant therapy for anal cancer – pro

Anal cancer is a rare clinical entity which represents 1–2% of all gastrointestinal tract cancers. Due to the paucity of this malignancy it has been difficult to establish generally accepted guidelines for treatment, although various therapy modalities have been evaluated. For a long time radical surgery was the primary treatment for anal cancer and still about 30% of the patients undergo abdominoperineal rectotomy. However, recurrence rates of

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Erbitux for anal cancer – pro

There is limited evidence for activity of irinotecana dn Erbitux for emtastatic squamous cell cancer of the anus. One is a case report of a a female patient with refractory anal cancer who achieved an excellent response to the combination of cetuximab and irinotecan after having failed single-agent irinotecan. The other is a report on 7 patients with metastatic anal cancer treated with cetuximab - a chimeric antibody against EGFR - on a compassionate

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Decitabine and epigenetic therapy for solid cancers – pro

Lay search: Decitabine is being studies for "epigenetic" therapy of solid cancers. Genes involved in all aspects of tumor development and growth can become aberrantly methylated in tumor cells, including genes involved in apoptosis and cell cycle regulation. Decitabine, 2´-deoxy-5-azacytidine, can inhibit DNA methyltransferases and reverse epigenetic silencing of aberrantly methylated genes. Nucleoside DNA methyltransferase inhibitors, such as decitabine,

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Metastatic anal cancer – pro

Metastatic anal cancer is not well studied in regard to chemo options for metastatic disease. NCCN recommends only 5FU and cisplatin or cisplatin for metastatic anal cancer. A recent review states: ". Metastatic disease develops in 10%–17% of patients treated with chemoradiation therapy. The most common site of distant metastasis is the liver. There are limited published data on the use of chemotherapy, particularly newer agents, to treat metastatic

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PET for anal cancer: anal canal versus anal margin – pro

Anal canal cancer metastasize more to the iliac nodes and of anal margin go more to the inguinal nodes. A  recent review found that the accuracy of PET scan was poor for anal cancer even with palpable inguinal nodes. PET scan sensitivity was  50%, specificity = 72%, predictive value positive (PVP) = 50%, predictive value negative = 80%. 64% of scans were performed within 6 months of treatment; in these, PVP = 33% and PVN = 66%. PET scanning for

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Erbitux for anal cancer – pro

There is limited evidence for activity of irinotecana dn Erbitux for emtastatic squamous cell cancer of the anus. One is a case report of a a female patient with refractory anal cancer who achieved an excellent response to the combination of cetuximab and irinotecan after having failed single-agent irinotecan. The other is a report on 7 patients with metastatic anal cancer treated with cetuximab - a chimeric antibody against EGFR - on a compassionate

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Combined Resection for Anal Cancer – pro

While a combined resection of rectal cancer and partial hepatectomy are well established, the same is not the case for anal cancer. Metastatic anal cancer is not well studied in regard to combined resection. NCCN recommends only 5FU and cisplatin or cisplatin for metastatic anal cancer. A recent review states: " Metastatic disease develops in 10%–17% of patients treated with chemoradiation therapy. The most common site of distant metastasis is

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