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Cancers
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Advances in Anal Cancer
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Advances in Anal Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 March 2025) | Viewed by 2500

Special Issue Editors

Dr. Evie H. Carchman

E-Mail Website
Guest Editor
1. Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
3. William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
Interests: HPV; anal cancer; cancer prevention
Special Issues, Collections and Topics in MDPI journals
Dr. Cristina B. Sanger

E-Mail Website
Guest Editor
1. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
2. William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
Interests: HPV; HIV; anal cancer

Special Issue Information

Dear Colleagues,

High-risk human papillomaviruses (HPVs) are responsible for ~5% of cancers worldwide, with an estimated 630,000 patients diagnosed with HPV-related cancers each year. Even with an established HPV vaccine, the incidence of anal cancer and other HPV-associated anogenital cancers has been increasing in incidence, especially in patients living with HIV. Screening programs are now more standard of practice for the precancerous lesions of anal cancer. However, it is still hard to risk stratify the resource-intense needs of the screening and treatment of precancerous lesions.

Despite the continued rise in the incidence and mortality of squamous-cell carcinoma of the anus (SCCA), there have been no significant changes in therapeutic options for these patients since the 1970s. To address the increase in SCCA, we clearly need new and more effective treatments. Given the rare nature of the disease, research on this problem is limited in clinical situations.

Developing an understanding of the complexity and variability of anal cancer will support the development of next-generation cancer preventative therapies and novel therapeutics to effectively control cancer development and progression, respectively.

This Special Issue will highlight the role of anal cancer covering both basic, (pre)clinical aspects and clinical research that advances our understanding of this rare human tumor.

Dr. Evie H. Carchman
Dr. Cristina B. Sanger
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • anal cancer
  • prevention
  • therapeutics
  • risk stratification

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Published Papers (3 papers)

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Research

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10 pages, 747 KiB  
Article
Carboplatin and Paclitaxel Chemoradiation for Localized Anal Cancer in Patients Not Eligible for Mitomycin and 5-Fluorouracil
by Alyssa K. DeZeeuw, Michael F. Bassetti, Evie H. Carchman, Charles P. Heise, Dana Hayden, Elise H. Lawson, Cristina B. Sanger, Ray King, Noelle K. LoConte, Sam J. Lubner, Jeremy D. Kratz and Dustin A. Deming
Cancers 2024, 16(17), 3062; https://doi.org/10.3390/cancers16173062 - 3 Sep 2024
Cited by 1 | Viewed by 1562
Abstract
Background: Although squamous cell carcinoma of the anus (SCCA) is a relatively uncommon malignancy in the United States, it continues to increase in incidence. Treatment for locoregional disease includes mitomycin and 5-fluorouracil with radiation. This combination is associated with significant toxicity, limiting its [...] Read more.
Background: Although squamous cell carcinoma of the anus (SCCA) is a relatively uncommon malignancy in the United States, it continues to increase in incidence. Treatment for locoregional disease includes mitomycin and 5-fluorouracil with radiation. This combination is associated with significant toxicity, limiting its use in patients who are older or have certain comorbidities. Carboplatin and paclitaxel (C/P) is an accepted treatment regimen for metastatic SCCA. We aim to evaluate the efficacy and toxicity of weekly C/P given with radiation for patients unable to receive standard chemoradiation for SCCA. Methods: From our cancer registry, adult patients who received weekly intravenous C/P concurrent with standard-dose radiation for localized SCCA were included in this study. Clinical response was determined based on the evidence of disease on imaging and/or anoscopy. Toxicities were graded according to the CTCAE v5. Results: Ten patients were included; eight were female, and the median age was 75.5 years (54–87). Six had T2 disease, and four had T3 tumors. Four had node-positive disease. The majority (70%) of patients were dosed at standard C (AUC 2) and P (50 mg/m2), with a limited subset requiring dose reduction for baseline performance status. Patients completed a mean of 78.3% (40–100%) of the intended treatments. A total of 89% of the patients achieved a complete clinical response. With a median follow-up of 25.8 months (3.4–50.4 months), 67% of the patients are alive and without recurrence. Two patients have had local recurrence, and one patient had metastatic progression. The most common toxicities of any grade included leukopenia (100%), anemia (100%), radiation dermatitis (100%), diarrhea (100%), and fatigue (100%). Grade 3 or higher toxicities included neutropenic fever (20%), neutropenia (30%), and anemia (30%). Conclusions: This study demonstrates promising tolerability and efficacy for weekly C/P chemoradiation for patients with anal cancer unable to receive mitomycin and 5-fluorouracil. This regimen merits further investigation in prospective clinical trials. Full article
(This article belongs to the Special Issue Advances in Anal Cancer)
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Review

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17 pages, 707 KiB  
Review
Advances in the Management, Treatment, and Surveillance of Anal Squamous Cell Cancer
by Cynthia Araradian, Maura Walsh, Hayley Standage and Vassiliki Liana Tsikitis
Cancers 2025, 17(8), 1289; https://doi.org/10.3390/cancers17081289 - 10 Apr 2025
Viewed by 389
Abstract
Anal cancer is a rare diagnosis, but incidence has been increasing over the past decade. Anal cancer is associated with the human papilloma virus (HPV), specifically the high-risk subtypes of 16 and 18. In addition, the precursor lesion for anal cancer is high-grade [...] Read more.
Anal cancer is a rare diagnosis, but incidence has been increasing over the past decade. Anal cancer is associated with the human papilloma virus (HPV), specifically the high-risk subtypes of 16 and 18. In addition, the precursor lesion for anal cancer is high-grade squamous intraepithelial lesions (HSILs) and its treatment and surveillance has been emphasized over the last 5 years. The current standard of care for anal cancer includes the Nigro protocol, concurrent chemoradiation, typically radiation with systemic mitomycin and 5-fluorouracil (5-FU). The protocol’s efficacy laid the foundation for sphincter preservation and non-operative management. This review will detail the essential clinical trials in the treatment and surveillance of premalignant lesions and anal squamous cell cancer, including alterations in radiation dosing, systemic chemotherapy, and immunotherapy over the last several decades. Full article
(This article belongs to the Special Issue Advances in Anal Cancer)
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Other

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21 pages, 738 KiB  
Systematic Review
A Systematic Review Defining Early Anal Squamous Cell Carcinoma and Identifying Treatment
by Cynthia Araradian, Mariah R. Erlick, Emmett Hunnicutt, J. Michael Berry-Lawhorn, Emily B. Rivet, Rebekka Duhen, Joseph Terlizzi, Tamzin Cuming and Sandy H. Fang
Cancers 2025, 17(10), 1646; https://doi.org/10.3390/cancers17101646 - 13 May 2025
Abstract
Background: Anal cancer screening has allowed for the diagnosis of early-stage anal cancers; however, guidelines for the treatment of early anal cancers remain mixed given the scarcity of clinical trials and data. Management ranges from chemoradiation therapy to local surgical excision. Methods: This [...] Read more.
Background: Anal cancer screening has allowed for the diagnosis of early-stage anal cancers; however, guidelines for the treatment of early anal cancers remain mixed given the scarcity of clinical trials and data. Management ranges from chemoradiation therapy to local surgical excision. Methods: This paper’s objective is to clarify the definition of early anal cancer and its management. Approval for this systematic review was obtained through PROSPERO [CRD42022304327]. Three independent reviewers screened the studies and performed data analysis, with conflicts resolved by a fourth reviewer. All information is presented according to the Preferred Reporting Item for Systematic Reviews and Meta-Analysis (PRISMA). The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria were used to assess the certainty of the evidence. Results: The MEDLINE, EMBASE and Cochrane databases were queried with 628 articles screened. A total of 15 articles were selected for inclusion. Early anal cancer was most often defined as T1-2N0M0 anal cancer but also included Superficially Invasive Squamous Cell Carcinoma (SISCCA). There were various treatments assessed for outcomes including local excision, chemoradiation, and radiation. The studies reported overall survival, cancer-specific survival, recurrence-free survival, and/or colostomy-free survival, leading to significant heterogeneity amongst the studies. No meta-analysis was possible. Conclusions: Poor-quality studies exist for the evaluation of the most effective treatment modality for early anal cancer. Surgical excision alone with adequate margins has equivocal results, but data is poor. Chemoradiation is successful but may be overtreatment. Randomized controlled studies are needed, as screening will result in earlier anal cancer diagnoses. Full article
(This article belongs to the Special Issue Advances in Anal Cancer)
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