Pooled Analysis of external-beam RADiotherapy parameters in phase II and phase III trials in radiochemotherapy in Anal Cancer (PARADAC)

Campo, Eleonor Rivin del; Matzinger, Oscar; Haustermans, Karin; Peiffert, D.; Glynne‐Jones, Robert; Winter, Kathryn; Konski, André; Ajani, Jaffer A.; Bosset, J.F.; Hannoun-Lévi, J.-M.; Puyraveau, Marc; Chakravarthy, A. Bapsi; Meadows, Helen; Northover, John; Collette, Laurence; Christiaens, Melissa; Maingon, P.

doi:10.1016/j.ejca.2019.08.022

Cited by 11 publications

(6 citation statements)

References 58 publications

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“…Likewise, delays/reductions and omissions of the second cycle of chemotherapy led to poorer PFS (hazard ratio 1.56 and 2.39, respectively) and OS (hazard ratio 1.92 and 2.88, respectively). These data were confirmed by a pooled analysis of individual patient data from seven phase II/III trials, in which longer overall treatment time led to higher rates of loco-regional failure, recurrence and death [27]. The prognostic importance of treatment compliance has also been reported in real-world populations.…”

Section: Recent Studies On Localised Anal Squamous Cell Carcinomamentioning

confidence: 65%

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Anal squamous cell carcinoma: standards of care, new data and ongoing clinical trials

Giunta

Bregni

Hendlisz

et al. 2021

Current Opinion in Oncology

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Purpose of reviewTo summarize current standards of care, discuss results of recent studies and present ongoing clinical trials for anal squamous cell carcinoma (ASCC). Recent findingsOver the last year, no practice changing studies have been reported in the setting of localised ASCC. A number of retrospective analyses, however, have provided practice-informing data, such as those confirming the negative impact of low compliance to chemoradiotherapy (CRT) on patient outcomes. In contrast, and for the first time, randomized evidence has become available to inform the management of advanced tumours. The InterAACT trial represents a key milestone in the evidence-building process for this disease, establishing carboplatin plus paclitaxel as a new standard of care for treatment-naı ¨ve advanced ASCC patients. Furthermore, more data have accumulated about the value of triplet chemotherapy in the first-line setting and of immune checkpoint inhibitors (either as single agents or in combination with other agents) in the refractory setting. SummaryRecent findings have the potential to improve the treatment quality standards and overall outcome of patients with either localised or advanced ASCC. Results from ongoing clinical trials will hopefully provide useful insights into the management of this disease and further shape current treatment paradigms.

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Section: Recent Studies On Localised Anal Squamous Cell Carcinomamentioning

confidence: 65%

“…New treatment options will hopefully become available in the near future for both localised and advanced ASCC. [27]. The prognostic importance of treatment compliance has also been reported in real-world populations.…”

Section: Key Pointsmentioning

confidence: 94%

Anal squamous cell carcinoma: standards of care, new data and ongoing clinical trials

Giunta

Bregni

Hendlisz

et al. 2021

Current Opinion in Oncology

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“…However, it highlights an important message that avoiding as much treatment interruptions as possible and reducing their duration seem to improve the patients’ outcome, pauses being increasingly questioned [ 29 ]. As a matter of fact, in a recent pooled analysis, shorter overall treatment time was associated with longer PFS [ 30 ]. Finally, a significant proportion of patients who entered in this model received an experimental drug (panitumumab) not standardly used, but this was taken into account in the model and did not seem to interfere with the outcome.…”

Section: Discussionmentioning

confidence: 99%

MRI-Based Radiomics Input for Prediction of 2-Year Disease Recurrence in Anal Squamous Cell Carcinoma

Giraud

Saut

Aparicio

et al. 2021

Cancers

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Purpose: Chemo-radiotherapy (CRT) is the standard treatment for non-metastatic anal squamous cell carcinomas (ASCC). Despite excellent results for T1-2 stages, relapses still occur in around 35% of locally advanced tumors. Recent strategies focus on treatment intensification, but could benefit from a better patient selection. Our goal was to assess the prognostic value of pre-therapeutic MRI radiomics on 2-year disease control (DC). Methods: We retrospectively selected patients with non-metastatic ASCC treated at the CHU Bordeaux and in the French FFCD0904 multicentric trial. Radiomic features were extracted from T2-weighted pre-therapeutic MRI delineated sequences. After random division between training and testing sets on a 2:1 ratio, univariate and multivariate analysis were performed on the training cohort to select optimal features. The correlation with 2-year DC was assessed using logistic regression models, with AUC and accuracy as performance gauges, and the prediction of disease-free survival using Cox regression and Kaplan-Meier analysis. Results: A total of 82 patients were randomized in the training (n = 54) and testing sets (n = 28). At 2 years, 24 patients (29%) presented relapse. In the training set, two clinical (tumor size and CRT length) and two radiomic features (FirstOrder_Entropy and GLCM_JointEnergy) were associated with disease control in univariate analysis and included in the model. The clinical model was outperformed by the mixed (clinical and radiomic) model in both the training (AUC 0.758 versus 0.825, accuracy of 75.9% versus 87%) and testing (AUC 0.714 versus 0.898, accuracy of 78.6% versus 85.7%) sets, which led to distinctive high and low risk of disease relapse groups (HR 8.60, p = 0.005). Conclusion: A mixed model with two clinical and two radiomic features was predictive of 2-year disease control after CRT and could contribute to identify high risk patients amenable to treatment intensification with view of personalized medicine.

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“…This allows for the reduction of acute toxicity, mainly in the perineal skin area, therefore a break in irradiation caused by skin radiation reaction is currently very rare. Studies have shown that interruptions in treatment reduce the effectiveness of local radiotherapy, so they should be avoided or shortened whenever possible [8]. Depending on the stage the most frequently used doses are 50-60…”

Section: Principles Of Radiation Therapymentioning

confidence: 99%

Nowotwory układu pokarmowego. Rak kanału i rak brzegu odbytu

Socha

Bujko

2021

Oncol Clin Pract

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Pooled Analysis of external-beam RADiotherapy parameters in phase II and phase III trials in radiochemotherapy in Anal Cancer (PARADAC)

Cited by 11 publications

References 58 publications

Anal squamous cell carcinoma: standards of care, new data and ongoing clinical trials

Anal squamous cell carcinoma: standards of care, new data and ongoing clinical trials

MRI-Based Radiomics Input for Prediction of 2-Year Disease Recurrence in Anal Squamous Cell Carcinoma

Nowotwory układu pokarmowego. Rak kanału i rak brzegu odbytu

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