Research on Anal Squamous Cell Carcinoma: Systemic Therapy Strategies for Anal Cancer.
Ryan M CarrZhaohui JinJoleen M HubbardPublished in: Cancers (2021)
Anal squamous cell carcinoma (ASCC) is a rare malignancy, with most cases associated with human papilloma virus and an increased incidence in immunocompromised patients. Progress in management of ASCC has been limited not only due to its rarity, but also the associated lack of research funding and social stigma. Historically, standard of care for invasive ASCC has been highly morbid surgical resection, requiring a permanent colostomy. Surgery was associated with disease recurrence in approximately half of the patients. However, the use of chemotherapy (5-fluorouracil and mitomycin C) concomitantly with radiation in the 1970s resulted in disease regression, curing a subset of patients and sparing them from morbid surgery. Validation of the use of systemic therapy in prospective trials was not achieved until approximately 20 years later. In this review, advancements and shortcomings in the use of systemic therapy in the management of ASCC will be discussed. Not only will standard-of-care systemic therapies for locoregional and metastatic disease be reviewed, but the evolving role of novel treatment strategies such as immune checkpoint inhibitors, HPV-based vaccines, and molecularly targeted therapies will also be covered. While advances in ASCC treatment have remained largely incremental, with increased biological insight, an increasing number of promising systemic treatment modalities are being explored.
Keyphrases
- squamous cell carcinoma
- ejection fraction
- healthcare
- newly diagnosed
- high grade
- palliative care
- bariatric surgery
- stem cells
- depressive symptoms
- risk factors
- coronary artery bypass
- quality improvement
- coronary artery disease
- locally advanced
- intensive care unit
- bone marrow
- social support
- hiv aids
- hepatitis c virus
- mental illness
- mesenchymal stem cells
- mechanical ventilation
- young adults
- radiation induced
- rectal cancer
- papillary thyroid
- chronic pain
- respiratory failure