title: Investigational drugs for treating anal cancer and future perspectives.
abstract: BACKGROUND
  Anal cancer is a relatively rare malignancy which comprises about 2.5% of all digestive system malignancies in the United States. The majority of cases are squamous cell carcinoma which is closely related to human papilloma virus (HPV) infection. Despite high cure rates with chemoradiation alone, 10 - 20% of patients do develop metastatic disease with little data to guide their treatment.
  
  
  METHODS
  In this review article, the authors describe the current standard treatment of early and advanced squamous cell carcinoma of the anal canal based on published data. The authors then describe the new approaches to the disease, focusing on new radio sensitizing agents, systemic targeted drugs and immunotherapy.
  
  
  CONCLUSIONS
  The authors believe that current standard treatment options for squamous cell carcinoma of the anal canal are well defined with acceptable results. However the major challenge in the treatment of anal cancer is the lack of randomized or even large single arm Phase II trials due to rarity of the disease, especially in the metastatic disease. But we are slowly making progress. Currently, the most promising areas of research are immunotherapy, targeted therapy and even HPV prevention. We are eagerly anticipating the results of these studies in order to expand the treatment armamentarium.
authors.affiliation: a Department of Gastrointestinal Oncology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL 33612 , USA.
authors.forename: Liliana
authors.initials: L
authors.lastname: Bustamante
authors.affiliation: b Department of Radiation Oncology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL 33612 , USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Frakes
authors.affiliation: b Department of Radiation Oncology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL 33612 , USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hoffe
authors.affiliation: a Department of Gastrointestinal Oncology , H. Lee Moffitt Cancer Center and Research Institute , Tampa , FL 33612 , USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001005:Anus Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D015195:Drug Design; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control
chemical_list: D000970:Antineoplastic Agents; D015507:Drugs, Investigational
keywords: anal cancer; chemotherapy; immunotherapy; targeted therapy