Prognostic biomarkers in squamous cell carcinoma of the anus: a systematic review

Lampejo, Temi; Kavanagh, D.; Clark, John R.; Goldin, Robert; Osborn, Michael; Ziprin, Paul; Cleator, S.

doi:10.1038/sj.bjc.6605984

Cited by 52 publications

(34 citation statements)

References 81 publications

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“…A recent systematic review examined 29 different biomarkers [22]. Tumour-suppressor genes p53 and p21 were the only biomarkers which were prognostic in more than one study.…”

Section: Personalised Medicinementioning

confidence: 99%

Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

Glynne‐Jones¹,

Nilsson²,

Aschele³

et al. 2014

Radiotherapy and Oncology

200

108

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Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5-8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer.

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“…A recent systematic review examined 29 different biomarkers [22]. Tumour-suppressor genes p53 and p21 were the only biomarkers which were prognostic in more than one study.…”

Section: Personalised Medicinementioning

confidence: 99%

Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

Glynne‐Jones¹,

Nilsson²,

Aschele³

et al. 2014

Radiotherapy and Oncology

200

108

View full text Add to dashboard Cite

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“…In a previous systematic review of 21 studies published before 2010, Lampejo et al identified 13 biomarkers associated with outcome in ASCC (Lampejo et al , 2010). Of these, only p53 and p21 were shown to have prognostic utility in more than one study, yet their value was not universally supported by the reported literature.…”

Section: Current Biomarkers Of Response To Chemoradiotherapymentioning

confidence: 99%

Biomarkers in anal cancer: from biological understanding to stratified treatment

et al. 2016

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Squamous cell carcinomas of the anus and anal canal represent a model of a cancer and perhaps the first where level 1 evidence supported primary chemoradiotherapy (CRT) in treating locoregional disease with curative intent. The majority of tumours are associated with infection with oncogenic subtypes of human papilloma virus and this plays a significant role in their sensitivity to treatment. However, not all tumours are cured with CRT and there remain opportunities to improve outcomes in terms of oncological control and also reducing late toxicities. Understanding the biology of ASCC promises to allow a more personalised approach to treatment, with the development and validation of a range of biomarkers and associated techniques that are the focus of this review.

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“…However, their effect on prognosis remains undetermined and are of only limited benefit in colorectal cancer. A recent trial showed anti-EGFR (Cetuximab) combined with chemoradiotherapy to be too toxic to deliver 52. In terms of treatment stratification, p16INK4a is also strongly associated with relapse in SCC of the anus and suggests targeting the EGFR in poor risk/recurrent anal cancer 52–54.…”

Section: Diagnosismentioning

confidence: 99%

Human Papilloma Virus and Squamous Cell Carcinoma of the Anus

Gami

Kubba

Ziprin

2014

Clin Med Insights Oncol

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The incidence of anal cancer is increasing. In the UK, the incidence is estimated at approximately 1.5 per 100,000. Most of this increase is attributed to certain at-risk populations. Persons who are human immunodeficiency virus (HIV)–positive and men who have sex with men (MSM), Organ transplant recipients, women with a history of cervical cancer, human papilloma virus (HPV), or cervical intraepithelial neoplasia (CIN) are known to have a greater risk for anal cancer. This paper will focus on HPV as a risk factor for anal intraepithelial neoplasia (AIN) and discusses the etiology, anatomy, pathogenesis, management of squamous cell carcinoma (SCC) of the anus.

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Prognostic biomarkers in squamous cell carcinoma of the anus: a systematic review

Cited by 52 publications

References 81 publications

Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

Anal cancer: ESMO–ESSO–ESTRO clinical practice guidelines for diagnosis, treatment and follow-up

Biomarkers in anal cancer: from biological understanding to stratified treatment

Human Papilloma Virus and Squamous Cell Carcinoma of the Anus

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