HealthDay News — Definitive chemoradiation (CRT) can potentially cure HIV-associated squamous cell carcinoma of the anal canal (SCCAC), with the addition of cetuximab resulting in less locoregional failure (LRF), according to a study published in the Journal of Clinical Oncology.
Joseph A. Sparano, MD, from the Montefiore Medical Center in Bronx, New York, and colleagues examined whether adding cetuximab to CRT would reduce LRF in 45 patients with stage I to III SCCAC and HIV infection. Participants received 45 to 54 Gy radiation therapy to the primary tumor and regional lymph nodes plus concurrent cetuximab and two cisplatin and fluorouracil cycles. Assuming a 35% LRF rate from historical data, the study was designed to detect at least a 50% reduction in three-year LRF.
The researchers found that the three-year LRF rate was 42% by binomial proportional estimate using the prespecified end point of LRF or alive without LRF, and was 20% by Kaplan-Meier estimate using definitions and methods consistent with historical data. The three-year rates for progression-free and overall survival were 72% and 79%, respectively, by Kaplan-Meier estimate. Twenty-six percent had grade 4 toxicity and 4% had treatment-associated deaths.
“HIV-associated SCCAC is potentially curable with definitive CRT,” the authors write. “Although addition of cetuximab may result in less LRF, the 20% recurrence and 26% grade 4 toxicity rates indicate the continued need for more-effective and less-toxic therapies.”
Several authors disclosed financial ties to pharmaceutical companies, including Eli Lilly, the manufacturer of cetuximab.
Sparano JA, Lee JY, Palefsky J, et al. Cetuximab plus chemoradiotherapy for HIV-associated anal carcinoma: a phase II AIDS malignancy consortium trial. J Clin Oncol. 2016. doi: 10.1200/JCO.2016.69.1642