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Related Concept Videos

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Modeling Oral-Esophageal Squamous Cell Carcinoma in 3D Organoids
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[Squamous cell anal carcinoma. What's next ?]

Stefano Kim1, Laurie Spehner2, Luc Cabel3

  • 1University of Bourgogne Franche-Comté, Inserm, EFS BFC, UMR1098, RIGHT, Interactions Greffon-Hôte-Tumeur/Ingénierie Cellulaire et Génique, 25000 Besançon, France; Department of Medical Oncology, University Hospital of Besançon, 25000 Besançon, France; Clinical Investigational Center, CIC-1431, 25000 Besançon, France; Oncology Multidisciplinary Group (GERCOR), 75011 Paris, France; French Federation of Digestive Cancerology (FFCD), 21000 Dijon, France.

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|January 11, 2021
PubMed
Summary

Advanced squamous cell carcinoma of the anus (SCCA) treatment shows promise with modified DCF chemotherapy. Immune responses, particularly CD4 Th1 cells and M-MDSC, are key prognostic factors for therapeutic efficacy.

Keywords:
Anal cancerBiomarkersBiomarqueursCancer du canal analChemotherapyChimiothérapieImmune responsesImmunotherapyImmunothérapieRéponses immunitaires

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Area of Science:

  • Oncology
  • Immunology

Background:

  • Squamous cell carcinoma of the anus (SCCA) incidence is rising, particularly metastatic forms.
  • Prognosis for localized SCCA remains poor, with high recurrence rates post-chemoradiotherapy.
  • Current treatment options for advanced SCCA have limitations.

Purpose of the Study:

  • To evaluate the efficacy of modified DCF (mDCF) chemotherapy in advanced SCCA.
  • To identify immunological parameters predicting treatment response in advanced SCCA.
  • To assess the utility of circulating tumor HPV DNA detection in SCCA management.

Main Methods:

  • Analysis of data from 115 patients in the Epitopes-HPV01 and Epitopes-HPV02 trials.
  • Evaluation of modified DCF (mDCF) and carboplatin-paclitaxel regimens.
  • Assessment of peripheral immune responses, including CD4 Th1 and M-MDSC.
  • Detection of circulating tumor HPV DNA using digital droplet PCR.

Main Results:

  • Modified DCF (mDCF) demonstrated high rates of sustained remissions and complete molecular responses in advanced SCCA.
  • Carboplatin-paclitaxel is a viable alternative for patients with contraindications to cisplatin or 5-FU.
  • Anti-PD-1/PD-L1 monotherapy showed limited efficacy in chemo-refractory patients (10-20%).
  • CD4 Th1 specific responses to telomerase and M-MDSC were identified as key prognostic factors for DCF efficacy.
  • Circulating tumor HPV DNA detection is highly sensitive and specific for SCCA.

Conclusions:

  • Modified DCF (mDCF) is the recommended treatment for advanced SCCA.
  • Immune profiling, specifically CD4 Th1 responses and M-MDSC, can guide SCCA treatment decisions.
  • Combination trials are ongoing to improve SCCA treatment outcomes.
  • Circulating tumor HPV DNA detection offers a valuable tool for SCCA management.