Abstract 7P
Background
Despite the favorable outcomes of chemoradiation (CRT) in locoregional squamous-cell carcinoma of the anus (SCCA), treatment of advanced disease remains a challenge due to the high rate of patients ineligible for radical CRT or failing to achieve complete response (CR) after CRT. The aim of this report is to evaluate the safety and outcomes of Carboplatin-Paclitaxel (CP) regimen used as induction chemotherapy (iCTx) to maximize the chance of achieving CR following CRT.
Methods
From Feb 2020 to May 2023, 16 consecutive pts with locally advanced SCCA not qualifying for primary CRT due to extensive involvement in pelvis, with stage IIIA (n=2), IIIC (n=11) and stage IV disease with pelvic metastases (n=3), with a median age of 62 years (range 37-73 years), received CP iCTx at National Institute of Oncology in Warsaw, Poland.
Results
All 16 pts received CP iCTx as planned, with a median treatment time of 39 days (range 15-127 days). After a median follow-up of 324 days (range 157-1134 days), 25% (n=4) incidence of grade 2 non-hematological toxicities occurred (n=1 diarrhea, n=1 urinary tract infection, n=1 fatigue and n=1 hypersensitivity to Paclitaxel). There were no grade 3-5 non-hematological toxicities. Grade 2 neutropenia occurred in 5 pts (31%) and 3 pts (19%) experienced grade 2 thrombocytopenia. There was a 12% (n=2) incidence of grade 3 neutropenia and 6% (n=1) incidence of grade 3 thrombocytopenia. One patient experienced grade 4 neutropenia. 14 pts (88%) reported a clinical response following iCTx with a 81% (n=13) incidence of improvement in pain control and 38% (n=6) incidence of reduction in tumor bleeding. After iCTx, 3 pts were ultimately disqualified from CRT due to progressive disease (n=2) and lack of response (n=1) and received palliative RT. The remaining 13 patients (81%) were qualified for CRT. 6 pts (38%) achieved long-term clinical CR. 2 pts (12%) achieved PR or CR with follow-up period too short to assess final response. 4 pts (25%) experienced treatment failure due to local recurrence (n=2) and distant metastases (n=2). One patient did not complete CRT due to urosepsis.
Conclusions
CP iCTx has an acceptable toxicity profile and is a viable option for patients with advanced SCCA to maximize the chance of achieving CR.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.