Metastatic anal cancer is not well studied in regard to chemo options for metastatic disease. NCCN recommends only 5FU and cisplatin or cisplatin for metastatic anal cancer A recent review states: ". Metastatic disease develops in 10%–17% of patients treated with chemoradiation therapy. The most common site of distant metastasis is the liver. There are limited published data on the use of chemotherapy, particularly newer agents, to treat metastatic anal carcinoma. Active agents include cisplatin plus 5-FU, carboplatin, doxorubicin, and semustine. Participation in a clinical trial should be discussed with all potentially eligible patients. "
I was not able to find credible literature supporting the use of Xeloda in this setting.Erbitux is a drug that is active in many different cancer typoes, both adenocarcinomas, f.e. of colon, and squamous, such as in head and neck. However, less is known about its rule for treatment of anal cancer or its role in combination with 5Fu, especially in the metastatic setting ( several combination therapies are lsited as being clinical trials for localized disease). NCCN lists only 5 Fu and cisplatin for metastatic anal cancer therapy.
Principles and Practice of Gastrointestinal Oncology (Hardcover)
by David P Kelsen (Editor), John M Daly (Editor), Scott E Kern (Editor), Bernard Levin Editor), Joel E Tepper (Editor) Publisher: Lippincott Williams & Wilkins; Second Edition edition (October 1, 2007), p.648
ISBN-13: 978-0781776172
nccn.org, anal cancer
American College of Radiology (ACR), Expert Panel on Radiation Oncology-Rectal/Anal Cancer. Anal cancer. Reston (VA): American College of Radiology (ACR); 2002. 11 p. (ACR appropriateness criteria). [31 references]
NCCN.ORG, Anal Cancer
Abeloff: Clinical Oncology 3rd Ed.-2004 , Ch. 82
Uronis, Hope E. , Bendell, Johanna C.
Anal Cancer: An Overview
Oncologist 2007 12: 524-534
American College of Radiology (ACR), Expert Panel on Radiation Oncology-Rectal/Anal Cancer. Anal cancer. Reston (VA): American College of Radiology (ACR); 2002. 11 p. (ACR appropriateness criteria). [31 references]
NCCN.ORG, Anal Cancer
Abeloff: Clinical Oncology 3rd Ed.-2004 , Ch. 82
Uronis, Hope E. , Bendell, Johanna C.
Anal Cancer: An Overview
Oncologist 2007 12: 524-534
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