Relapsed refractory metastatic squamous cell cancer of anal canal in a patient with retroviral infection responding to cetuximab

2019 ◽  
Vol 26 (4) ◽  
pp. 1025-1028
Author(s):  
Jaren Lerner ◽  
Miguel Michel ◽  
Constantin A Dasanu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Anal Carcinoma ◽  
Clinical Trial Data ◽  
Curative Intent ◽  
Retroviral Infection ◽  
Line Therapy

Introduction Conventional first-line therapy for squamous cell carcinoma of anal canal is definitive chemoradiotherapy with a curative intent. Due to the efficacy of treatment for locoregional disease and rarity of metastatic anal carcinoma, clinical trial data for treatment of metastatic disease is lacking. Case report Herein, we describe a patient with relapsed, metastatic squamous cell carcinoma of the anal canal treated with cetuximab as the third-line therapy. Management and outcome: The patient responded to this pharmacological agent, meeting the definition of a partial response per response evaluation criteria in solid tumors (RECIST). Discussion EGFR inhibitors are potential avenues for the subsequent lines of therapy in metastatic or relapsed/refractory anal cancer. Prospective clinical trials of cetuximab alone or in combination with other agents are warranted in this setting in the future.

Post-treatment surveillance in locally advanced squamous cell carcinoma (SCCA) of the anal canal: A global subspecialist survey.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 573-573 ◽  
Author(s):  
Cathy Eng ◽  
Richard A. Adams ◽  
Lisa A. Kachnic ◽  
Prajnan Das ◽  
Randy Devereux Ernst ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Anal Cancer ◽  
Squamous Cell ◽  
Working Group ◽  
Locally Advanced ◽  
Anal Carcinoma ◽  
International Consensus ◽  
Curative Intent

573 Background: Squamous cell carcinoma of the anal canal will be diagnosed in 28,000 individuals globally. Considered a rare cancer, the incidence of anal carcinoma continues to rise annually. Majority of patients present with locally advanced disease in which concurrent chemoradiation (CRT) will be provided with curative intent. The Anal Cancer IRCI Working Group was created to pursue novel approaches to the diagnosis, treatment, and surveillance of patients. Yet, surveillance following completion of CRT is not well established and varies as per NCCN (v2.2015) and ESMO guidelines. Methods: A 22-question survey provided to anonymous international GI subspecialists in various fields. Questions pertained to timing and type of diagnostic imaging, surveillance interval, approach to detection of complete response (CR), and prevention of sexual dysfunction. Results: Survey distribution was initiated in March 2015 and still ongoing. Thus far, 96 physicians responded. Conclusions: Carcinoma of the anal canal continues to rise in incidence annually. Surveillance following completion of CRT is warranted; however, global variability in practice patterns for surveillance exists. As such, the IRCI Anal Cancer Working Group intends to provide an international consensus surveillance statement. [Table: see text]

scholarly journals So Now My Patient Has Squamous Cell Cancer: Diagnosis, Staging, and Treatment of Squamous Cell Carcinoma of the Anal Canal and Anal Margin

2018 ◽  
Vol 31 (06) ◽  
pp. 353-360 ◽  
Author(s):  
Cindy Kin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Surgical Excision ◽  
Chemoradiation Therapy ◽  
Anal Margin ◽  
Delay In Diagnosis ◽  
Delayed Treatment

AbstractSquamous cell carcinomas of the anal canal and the anal margin are rare malignancies that are increasing in incidence. Patients with these tumors often experience delayed treatment due to delay in diagnosis or misdiagnosis of the condition. Distinguishing between anal canal and anal margin tumors has implications for staging and treatment. Chemoradiation therapy is the mainstay of treatment for anal canal squamous cell, with abdominoperineal resection reserved for salvage treatment in cases of persistent or recurrent disease. Early anal margin squamous cell carcinoma can be treated with wide local excision, but more advanced tumors require a combination of chemoradiation therapy and surgical excision.

Curative intent of local excision alone for stage I anal canal squamous cell carcinoma (ACSCC).

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e15574-e15574
Author(s):  
Zhaohui Jin ◽  
Sakti Chakrabarti ◽  
Brandon M Huffman ◽  
Christopher Leigh Hallemeier ◽  
Joleen Marie Hubbard ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Local Excision ◽  
Squamous Cell ◽  
Stage I ◽  
Curative Intent

scholarly journals 517P Early stage squamous cell carcinoma of the anal canal: Results of curative-intent therapy in a multicenter retrospective study

2020 ◽  
Vol 31 ◽  
pp. S458
Author(s):  
I.K.F. Lustosa ◽  
M.P.G. Camandaroba ◽  
B.R.S. Mattos ◽  
S.F. Silva ◽  
S. Iseas ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Retrospective Study ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Curative Intent

Choice of chemotherapy in the treatment of metastatic squamous cell carcinoma of the anal canal.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4060-4060 ◽  
Author(s):  
Cathy Eng ◽  
Jane Rogers ◽  
George J. Chang ◽  
Y. Nancy You ◽  
Prajnan Das ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Metastatic Disease ◽  
Squamous Cell ◽  
First Line ◽  
Curative Intent ◽  
Metastatic Squamous Cell Carcinoma ◽  
Line Chemotherapy

4060 Background: Metastatic squamous cell carcinoma (SCCA) of the anal canal is an uncommon malignancy with no standard approach. The reported median overall survival (OS) is 9-12 months (M) following 5-FU + cisplatin (FC)-based therapy. The aim of this study is to evaluate first-line chemotherapy approaches in this patient (pt) population. Methods: A retrospective analysis was conducted of 428 pts with metastatic SCCA of the anal canal identified from the MDACC tumor registry between 1/1/2000 - 5/31/2011. Electronic medical records were reviewed for histology, date of diagnosis and/or recurrence, site of metastasis, type of therapy provided, response rate (RR), progression-free survival (PFS), OS, and lines of salvage therapy. All eligible pts were required to be treatment-naïve for metastatic disease and have radiographic imaging at MDACC. Waiver of informed consent was obtained. Results: 99 pts fulfilled all criteria; 10 were lost to follow-up; 12 did not initiate chemotherapy. 77 pts were evaluable; M: F = 20:57; median age = 55 years (range: 37 - 82); HIV(+) = 5% (4/77); prior chemoXRT with curative intent: 70% (54/77), complete response (CR): 87% (47/54), median time to development of metastatic disease =17M. 29% (22/77) presented with metastatic disease. Sites of disease included distant lymph nodes (41%); liver (45 %); lung (25%); bone (15%); and brain (8%). The median follow up was 37M. 73% (56/77) of patients were treated with platinum-based therapy; 51% (n=39) received FC and 22% (n= 17) received carboplatin + paclitaxel (CP). The median PFS was 6M; FC trended better than CP for PFS (7M vs. 5M, p<0.067). The overall median OS = 29M. 40% (31/77) of pts received neoadjuvant first-line therapy followed by metastasectomy (68%), XRT (26%), or both (6%); resulting in a median OS = 35M. Conclusions: Metastatic SCCA of the anal canal is a malignancy in which 5-FU+cisplatin is a commonly used regimen. Our analysis suggests FC results in improved PFS over CP but is underpowered supporting further analysis. The short median PFS with front-line chemotherapy, and yet longer OS reflects the challenges in treating this patient population and the importance of multidisciplinary management in select cases.

Association of human papillomavirus with unique clinicopathologic features in patients with metastatic squamous cell carcinoma of the anal canal.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 479-479
Author(s):  
Van Karlyle Morris ◽  
Asif Rashid ◽  
Miguel A. Rodriguez-Bigas ◽  
Prajnan Das ◽  
Robert A. Wolff ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Anal Carcinoma ◽  
The United States ◽  
Published Data ◽  
Hpv Status ◽  
Metastatic Squamous Cell Carcinoma

479 Background: The incidence of anal carcinoma in the United States continues to increase steadily, and infection with the human papillomavirus (HPV) is an established risk factor for the development of anal carcinoma. However, clinicopathologic characteristics of patients with metastatic squamous cell carcinoma of the anal canal according to HPV status have thus far not been defined. Methods: Records of patients treated for metastatic squamous cell carcinoma of the anal canal at the MD Anderson Cancer Center between June 2005 and August 2013 were reviewed. Patients were tested for the presence of HPV DNA by in-situ hybridization and/or the p16 oncoprotein by immunohistochemistry. Associations between the presence of HPV and clinicopathologic attributes were measured by calculation of odds ratios, and survival was estimated according to the Kaplan-Meier method. Results: Patients were followed for a mean of 50.2 months, and the mean age at diagnosis was 54.0 years. Among the 43 patient records reviewed, 39 tumors (90.1%) tested positive for the presence of HPV. Patients with HPV-negative tumors were more likely to have a strong (> 30 pack-year) tobacco history (OR=18.5, p=0.018) and were more likely to develop brain metastases (OR=2.0, p=0.04). A faint association was observed between Caucasian ethnicity and HPV-positive tumors (OR=8.8, p=0.06). Median survival from the time of diagnosis of metastatic disease was 42.4 months, with a trend towards a worse survival seen among patients with HPV-negative tumors (HR for death 4.9, p=0.09). Conclusions: Differences in HPV status and prior tobacco exposure may identify two separate populations of patients with metastatic squamous cell anal carcinoma with different clinicopathologic phenotypes. Our results are similar to prior published data in patients with squamous cell carcinoma of the head and neck in which patients with HPV-positive tumors demonstrate improved survival outcomes. Data from additional patients will be presented.

Primary squamous cell carcinoma of the ampulla of Vater: management and review of the literature

2021 ◽  
Vol 14 (1) ◽  
pp. e236477
Author(s):  
Subhash Soni ◽  
Poonam Elhence ◽  
Vaibhav Kumar Varshney ◽  
Sunita Suman
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Survival Rates ◽  
Ampulla Of Vater ◽  
Metallic Stent ◽  
Biological Behaviour ◽  
Curative Intent ◽  
Term Survival ◽  
History Of

Squamous cell carcinoma (SCC) of the ampulla of Vater is a rare pathology and only few cases are reported in the literature. With limited experience of primary SCC in the ampulla of Vater, its biological behaviour, prognosis and long-term survival rates are not well known. A 38-year-old woman presented with a history of painless progressive jaundice for which self-expending metallic stent was placed 3 years back. She was evaluated and initially diagnosed as probably periampullary adenocarcinoma. She underwent pancreaticoduodenectomy and histopathology with immunohistochemistry was suggestive of SCC of ampulla of Vater. She received adjuvant chemotherapy and doing well with no recurrence after 1 year of follow-up. In conclusion, SCC of the ampulla is an unusual pathology that should be kept as a differential diagnosis for periampullary tumours. Surgical treatment with curative intent should be performed whenever feasible even in the setting of bulky tumour to improve the outcome.

scholarly journals Pan-ERBB kinase inhibition augments CDK4/6 inhibitor efficacy in oesophageal squamous cell carcinoma

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323276
Author(s):  
Jin Zhou ◽  
Zhong Wu ◽  
Zhouwei Zhang ◽  
Louisa Goss ◽  
James McFarland ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Large Scale ◽  
Cell Cancer ◽  
Oesophageal Squamous Cell Carcinoma ◽  
Squamous Cancer ◽  
Striking Success

ObjectiveOesophageal squamous cell carcinoma (OSCC), like other squamous carcinomas, harbour highly recurrent cell cycle pathway alterations, especially hyperactivation of the CCND1/CDK4/6 axis, raising the potential for use of existing CDK4/6 inhibitors in these cancers. Although CDK4/6 inhibition has shown striking success when combined with endocrine therapy in oestrogen receptor positive breast cancer, CDK4/6 inhibitor palbociclib monotherapy has not revealed evidence of efficacy to date in OSCC clinical studies. Herein, we sought to elucidate the identification of key dependencies in OSCC as a foundation for the selection of targets whose blockade could be combined with CDK4/6 inhibition.DesignWe combined large-scale genomic dependency and pharmaceutical screening datasets with preclinical cell line models, to identified potential combination therapies in squamous cell cancer.ResultsWe identified sensitivity to inhibitors to the ERBB family of receptor kinases, results clearly extending beyond the previously described minority of tumours with EGFR amplification/dependence, specifically finding a subset of OSCCs with dual dependence on ERBB3 and ERBB2. Subsequently. we demonstrated marked efficacy of combined pan-ERBB and CDK4/6 inhibition in vitro and in vivo. Furthermore, we demonstrated that squamous lineage transcription factor KLF5 facilitated activation of ERBBs in OSCC.ConclusionThese results provide clear rationale for development of combined ERBB and CDK4/6 inhibition in these cancers and raises the potential for KLF5 expression as a candidate biomarker to guide the use of these agents. These data suggested that by combining existing Food and Drug Administration (FDA)-approved agents, we have the capacity to improve therapy for OSCC and other squamous cancer.

scholarly journals Description of the genetic variants identified in a cohort of patients diagnosed with localized anal squamous cell carcinoma and treated with panitumumab

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lucía Trilla-Fuertes ◽  
Angelo Gámez-Pozo ◽  
Joan Maurel ◽  
Rocio Garcia-Carbonero ◽  
Jaume Capdevila ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Clinical Practice ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Genetic Variants ◽  
Anal Carcinoma ◽  
Genetic Alterations ◽  
Daily Clinical Practice ◽  
Complete Regression ◽  
Anal Squamous Cell Carcinoma

AbstractSquamous cell carcinoma is the most frequent histologic type of anal carcinoma. The standard of care since the 1970s has been a combination of 5-fluorouracil, mitomycin C, and radiotherapy. This treatment is very effective in T1/T2 tumors (achieving complete regression in 80–90% of tumors). However, in T3/T4 tumors, the 3-year relapse free survival rate is only 50%. The VITAL trial aimed to assess the efficacy and safety of panitumumab in combination with this standard treatment. In this study, 27 paraffin-embedded samples from the VITAL trial and 18 samples from patients from daily clinical practice were analyzed by whole-exome sequencing and the influence of the presence of genetic variants in the response to panitumumab was studied. Having a moderate- or high-impact genetic variant in PIK3CA seemed to be related to the response to panitumumab. Furthermore, copy number variants in FGFR3, GRB2 and JAK1 were also related to the response to panitumumab. These genetic alterations have also been studied in the cohort of patients from daily clinical practice (not treated with panitumumab) and they did not have a predictive value. Therefore, in this study, a collection of genetic alterations related to the response with panitumumab was described. These results could be useful for patient stratification in new anti-EGFR clinical trials.

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