Anal Carcinoma

Phs II study of nivolumab with or without ipilimumab in refractory, metastatic squamous cell carcinoma of the anal canal #WCGIC2023 👉Trend for higher efficacy with dual ICI, but also more toxicity 👉We need predictive biomarkers @myESMO @OncoAlert @WCGIC (@ArndtVogel)

Excellent discussion @Juanmaoconnor!! "Genomic landscape of appendiceal adenocarcinoma" @michaelwhitewx and "Nivo with or without ipilimumab in m squamous cell carcinoma of the anal canal" @VanMorrisMD #WCGIC2023 (@CataniGreta)

Come and check P-284 at #WCGIC2023 titled "SBRT for liver M1 of CCR and anal cancer pts". @OncoSantPau by @BertaMartn2 @dapalobra @dravirgili @SebioAna @FJPMateo @DrMirallas ✅ Molecular status can predict a worse control rate. Keep enjoying Oncology! (@AidaPiedraMD)

Excellent talks so far by experts Sheela Rao on Anal cancers and @DucreuxMichel on small bowel cancer. Join us for the rest of the session #wgic2023 @myESMO (@MyriamChalabi)

(hopefully not much vaginal stenosis after #ProstateCancer treatment 😉, but the point is very important--and under appreciated--for gyn and anal malignancies, etc.) (@TylerSbrt)

Not an MD, but went through a colposcopy and biopsy (no anesthesia + it hurt more than the 9+ pound babies I delivered naturally) and a LEEP. Consequently, my sons and daughters all got the HPV vax @ 12. They + their partners are safer from cervical, anal, + HNT cancers. (@trepanoah)

Fantastic job today by our @MSKCancerCenter fellows discussing 5-year OPRA data, use of ctDNA in anal cancer and the ongoing Janus trial; well done Floris and Janet! @DrGarciaAguilar would be proud! @ASCO #ASCO23 (@JoshSmithMDPhD)

HPV causes anal cancer, as well as other cancers not specific to gender. Boys should be vaccinated. (@ElsieD599)

At the 2023 Great Debates and Updates in Gastrointestinal Malignancies #GDUGI meeting, Cathy Eng, MD, offered her perspectives on the current and upcoming clinical trials for treatments of anal cancer. Learn more: https://t.co/Lt4QoV8W69 @GreatDebatesCME @CathyEngMD (@OncLearnNetwork)

New pub: Outcomes of neoadjuvant therapy for stage II-III anal adenocarcinoma; results from a propensity-score matched analysis #ColorectalSurgery @CleveClinicFL @SWexner @nirhoresh @ZGaroufalia @RachellGefen @PZhou_MD https://t.co/p0DmxbpLyL (@dr_samehhany81)

This is really good stuff - careful work to find out how to reduce the side effects of curative RT for anal cancer - obviously long term FU essential but so far so good #prda #RT (@Maherjane)

Extended follow up would hopefully change SOC with reduce dose for early stage anal cancer (@Sushilberiwal)

Definitely having ESTRO FOMO & ❤️y’all tweeting updates, esp PLATO ACT4! Have long suspected SOC may be “overkill” for some w/ early stage anal cancer. ACT4 & ECOG DECREASE should be supported to see if we can safely deescalate & improve QOL while maintaining excellent CR rates (@DrEmmaHolliday)

Preliminary results from ACT4: ↔️efficacy with ↘️ toxicity and ↗️compliance in early stage anal cancer with de-escalated CTRT (@isteddos)

ACT 4 of Plato RCT of n=160 patients investigating dose de-escalation in anal cancer. ~90% complete response at 6 months in both arms. ⬇️Reduced dose IMRT #radiotherapy had rebound in sexual function at 6 mo. Longer term data pending! #radonc #ESTRO2023 (@_ShankarSiva)

Alexandra Gilbert gives an excellent and clear update on the PLATO ACT4 trial in anal canal cancer. ➡️ Reduced toxicity, better RT and Chemo compliance with reduced dose IMRT arm #ESTRO23 @CR_UK (@gerryhanna)

Case in point: 0529 mainstreamed IMRT for anal cancer. It never met primary end point. It did show decreased grade 3 tox relative to 3D. Similar story for PASSPORT trial improving xerostomia. New modalities have to put up (they haven't). (@olusolaodavies)

I love this paper. It is of course de-escalation but it is done very thoughtfully and 30/15 for elective makes some sense if you consider that OG Wayne state protocol for anal cancer used 30 Gy for gross dz for hpv positive. (@ParikhSimul)

Shout out to my @GuildConference co-fellow @JustinFieldMD presenting his work on anal cancer risk in MSM with IBD @DDWMeeting Reminding all of us to remember to take a sexual history 📝 in all patients with IBD. @UmaMahadevanIBD (@JessSheehanMD)

Thank you @Jonathansegal85 🙏🏻 The 2 MSM IBD patients with anal SCC in our study had good long term survival, although often not the case in IBD patients with anal cancer. Perhaps MSM status allowed for earlier detection due to existence of screening guidelines in this grp (@JustinFieldMD)

If toxicity is high enough with existing SOC, then clinically meaningful reduction with new tech certainly could justify new SOC. Who would prefer 3D over IMRT for advanced HN/anal cancers? (@MikeChuongMD)

We already know it does! As well as vaginal, vulvar, penile, & anal cancers, and genital warts Plus if you get it before 15 it’s 2 doses instead of 3 (@roadcoconut)

#TumorBoardTuesday What if the ctDNA tests OVERdetect? Did I mention my patient with anal squamous cell cancer who had an EGFR mutation on ctDNA testing? In the end it was a clonal hematopoeisis mutation - a total red herring😡 (@MPishvaian)

Anal cancer: @eaonc 2182 DECREASE: de-intensification for T1-2N0 anal SCC Pancreas: In development - utility of dose escalation? 3y OS to see benefit of local Tx in pts without early progression Stay tuned for future developments! #NRG2023 (@A_CT_SimMDJD)

Signatera #ctDNA in Anal Cancer presented by Dr Janet Alvarez of @MSKCancerCenter. Early and reliable response assessment. 100 days on average before traditional restaging methods. @JoshSmithMDPhD ()

Extensive molecular profiling in the #CARACAS random ph 2 trial! Our Investigators showed that PDL1 CPS high or TMB high are associated with better outcomes in anal cancer patients. #EJC #raretumors @sara_lonardi1 @FilippoPietran4 @ChiaraCrem1 @paomanca https://t.co/syW37EP4vK (@FoundationGono)

A good attempt finding biomarkers to predict outcome for immunotherapy in pretreated anal cancer in translational analysis of CARACAS study in European journal of Cancer (IO+- anti-EGFR) TMB>10 PDL1 CPS>40. Why would this squamous cancer not be IO-sensitive? (@FilipHerpe)

Response to erdafitinib was rapid with clinical improvement noted soon after initiation of Tx Subsequent imaging showed significant shrinkage In collaboration with @carisls, we identified FGFR3 R669G in various tumors including NSCLC, GMB, HNC, pancreatic/anal/bladder cancers (@chulkimMD)

2/3 Diagnosed Squamous Cell Cancer of the anus (not a known Lynch risk) HPV-negative, dMMR, MSI-high, MLH1-positive, thanks to surgeon who listened and ordered pathology. Many diagnosed of anal cancer are missed until Stage 4. (@paige_van_pelt)

Impressed how some topics come up in 3-5 Qs from ASCO SEP & I expect to be locks on ABIM test: T-DM1 for HER2+ breast cancer after neoadj, consol durva for st 3 NSCLC, MAP post-op chemo for osteosarc, cont f/u after cCRT out to 26 wks for anal cancer need to make a list to share (@JackWestMD)

Just for clarification,EA2201 is specifically for MSI-H rectal cancer patients. Regardless, MSI-H testing is encouraged in ALL solid tumors. So for an MSI-H anal cancer, I believe it is likely your doctor would discuss with you the role of I/O from the beginning. @VUMC_Cancer (@CathyEngMD)

I am just a MSI-H/dMMR stage 3a anal cancer patient, but KN177, by not being first line treatment, continues to muddy the waters for PD1-therapy and prevent those of us with Lynch Syndrome from getting the therapy we need when first diagnosed. Why use 5FU-chemo on us? (@paige_pelt)

They do: confirmed PR in anal cancer (post Libtayo, Tecentriq + ICOS); unconfirmed PR in uveal melanoma (post Opdivo + Yervoy) $RUBY (@JacobPlieth)

Also important to emphasize #cholangiocarcinoma #HPBCSM #PANCSM. #BRAFV600E #AnalCancer #CRCSM Other than #colorectalcancer whereby you need the EGFR⛔️upstream, all tumor types data that I’ve seen published and clinically respond to RAF/MEK⛔️. Needs agnostic approval. ❓ 💭 (@pashtoonkasi)

@DocCatenacci seems like in our experience, it is more so the sequence & not necessarily the combination. PD1⛔️⏩⏩Chemo➕/➖VEGF⛔️ Chemo📉⬇️Tregs We saw it ē DCF in anal cancer👉🏽 https://t.co/0GPpXm0w74 Table shows agnostic effect👇🏽 @mdmanishshah worth a cooperative group💡? (@pashtoonkasi)

ORR 10% w/pembro (KEYNOTE158) for met #analcancer. Rare responses are durable but we need to do better! Activated @MDAndersonNews #immunotherapy combo trials for met anal cancer target: -PD-1+/-CTLA-4 -PD-L1+HPV DNA vaccine -PD-L1+OX40 -EGFR+TGF-B #ASCO20 #ancsm @HPVAnalCancer (@VanMorrisMD)