علاج الخط الأول لسرطان الشرج ذو الخلايا الحرشفية مع مرض نقيلي خارج الحوض

References

DOI: 10.6004/jnccn.2023.0030

• Systemic therapy is generally recommended for extrapelvic metastatic disease.
• Based on results from the phase II International Multicentre InterAACT study, carboplatin in combination with paclitaxel has been noted as the preferred regimen for first-line treatment of metastatic anal cancer by the NCCN Panel.
• Other recommended treatment options include 5-FU, leucovorin, and cisplatin (FOLFCIS); 5-FU, leucovorin, and oxaliplatin (FOLFOX); 5-FU + cisplatin (category 2B reflecting its similar efficacy, but higher toxicity, when compared with carboplatin + paclitaxel in a randomized trial); or modified docetaxel, cisplatin, and 5-FU (DCF, category 2B).
• With use of FOLFOX, the panel recommends strong consideration of discontinuation of oxaliplatin after 3-4 months (or sooner for unacceptable neurotoxicity) while maintaining other agents until time of disease progression.