Paclitaxel for the treatment of anal cancer after cisplatin and 5-fluorouracil

Abstract

Introduction: Squamous cell cancer of the anal canal (anal cancer) is a rare disease but its incidence is increasing worldwide. Although combined therapy of 5-fluorouracil (5-FU), mitomycin, and radiation is the treatment of choice for locoregional anal cancer, the treatment of metastatic disease is less established. The combination of 5-FU and cisplatin has been adopted as the first-line treatment of choice for the treatment of metastatic disease, based on several phase II studies. However, no standard treatment has been established for stage IV anal cancer after failure of this combination. Paclitaxel, a chemotherapeutic agent that stabilizes microtubules, has established clinical activity in squamous cell cancer of the head and neck. A previous report described the activity of paclitaxel in five patients with anal cancer. Methods: In this report, we describe our experience using this agent in six patients with metastatic anus cancer with prior progression with cisplatin and 5-FU. Results: Four patients had an objective response and one patient presented with stable disease. Conclusion: Our results confirmed the activity of weekly paclitaxel in patients with metastatic anal cancer with 5-FU and cisplatin-resistant.