title: DCF (docetaxel, cisplatin and 5-fluorouracil) chemotherapy is a promising treatment for recurrent advanced squamous cell anal carcinoma.
abstract: BACKGROUND
  Squamous cell carcinoma of the anal canal (SCCA) is a rare disease, mostly diagnosed at early stage. After concurrent chemoradiation (CRT) with mitomycin C and 5-fluorouracil (5FU), local or metastatic recurrences occur in >20% of the patients. After treatment failure, cisplatin (CDDP)-based chemotherapy is the standard option, but complete response (CR) is a rare event and the prognosis remains poor.
  
  
  METHODS
  Eight consecutive patients with advanced recurrent SCCA after CRT were treated with DCF regimen (docetaxel 75 mg/m(2) day 1, CDDP 75 mg/m(2) day 1 and 5FU at 750 mg/m(2)/day for 5 days every 3 weeks). Tumour samples were analysed for human papillomavirus (HPV) genotyping, as well as p16 and p53 expression.
  
  
  RESULTS
  After a median follow-up of 41 months, the overall survival rate at 12 months was 62.5% (95% CI 22.9-86.1 months). Four patients achieved a complete remission and remain relapse-free at the time of analysis with a progression-free survival of 19, 33, 43 and 88 months. Three of these patients underwent surgery for all involved metastatic sites. For all of them, pathological CR was confirmed. DCF regimen appeared feasible in these patients previously exposed to pelvic CRT, and no grade IV toxicity occurred. All patients in complete remission had HPV-16-positive SCCA, while HPV could only be detected among 50% of the non-responding patients. Of interest, immunohistochemical study revealed a p16(+)/p53(-) phenotype in these patients, while none of non-responders expressed p16.
  
  
  CONCLUSIONS
  The high level of complete and long-lasting remission among SCCA patients treated with DCF regimen supports the assessment of this strategy in prospective cohorts.
authors.affiliation: Department of Medical Oncology, University Hospital of Besançon, Besançon.
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Jary
authors.forename: L
authors.initials: L
authors.lastname: Mansi
authors.forename: B
authors.initials: B
authors.lastname: Benzidane
authors.forename: A
authors.initials: A
authors.lastname: Cazorla
authors.forename: M
authors.initials: M
authors.lastname: Demarchi
authors.forename: T
authors.initials: T
authors.lastname: Nguyen
authors.forename: A
authors.initials: A
authors.lastname: Kaliski
authors.forename: E
authors.initials: E
authors.lastname: Delabrousse
authors.forename: F
authors.initials: F
authors.lastname: Bonnetain
authors.forename: P
authors.initials: P
authors.lastname: Letondal
authors.forename: J F
authors.initials: JF
authors.lastname: Bosset
authors.forename: S
authors.initials: S
authors.lastname: Valmary-Degano
authors.forename: C
authors.initials: C
authors.lastname: Borg
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D052162:Human papillomavirus 16 / Q000235:genetics; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D018307:Neoplasms, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000821:virology; D030361:Papillomavirus Infections / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D011446:Prospective Studies; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
keywords: DCF; HPV; anal cancer; docetaxel; squamous cell carcinoma; taxane