Abstract 516P
Background
Anal cancer represents an uncommon malignancy, with 10 to 20% of cases developing metastasis. There are few data on treatment of metastatic anal cancer (MAC). We aimed to evaluate prognostic factors in these patients (pts), with a focus on outcomes from HIV-infected pts.
Methods
Retrospective multicenter study of consecutive pts with diagnosis of synchronic or metachronic MAC. The primary endpoints were overall survival (OS) and progression free survival (PFS) from first cycle of first line therapy. Prognostic factors among those treated with chemotherapy were evaluated by univariate and multivariate Cox proportional hazard models, according to HIV status.
Results
From Mar 2006 to Jan 2020, 113 pts were included: 78 (69%) were female; 104 (92%) had ECOG 0 and 1; 39 (34.5%) had synchronic MAC and 20 (17.6%) had HIV. 101 received chemo (89.3%): cisplatin and 5-FU 56 (49.5%), carboplatin and paclitaxel 24 (21.2%). Eleven percent were managed by best supportive care only. In a median follow-up of 26.0 months (95% confidence interval [CI]: 14.7 - 37.4), PFS was 5.5 months (95% CI: 3.8 - 7.2) and OS was 14.6 months (95% CI: 11.4 - 17.9). Compared with HIV-positive, HIV-negative pts were younger (median age 45 vs 61.5 years [p< 0.001]); response in first line was 41.2% vs 34.5% (p=0.96); median PFS was 4.9 vs 5.5 months (p=0.76) and OS was 11.3 vs 14.6 months (p=0.91). Any prognostic factor was identified by multivariable analyses.
Conclusions
HIV-positive pts with MAC are younger, present similar PFS to first line platin-based regimens and OS when compared to those without HIV infection. Larger studies and trials of MAC should include HIV-infected pts to increase the amount of evidence on the outcomes of these pts.
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.