Experimental Hematology & Oncology (Jul 2023)

DCF versus doublet chemotherapy as first-line treatment of advanced squamous anal cell carcinoma: a multicenter propensity score-matching study

  • Stefano Kim,
  • Véronique Vendrely,
  • Angélique Saint,
  • Thierry André,
  • Pauline Vaflard,
  • Emmanuelle Samalin,
  • Simon Pernot,
  • Oliver Bouché,
  • Mustapha Zubir,
  • Jérôme Desrame,
  • Christelle de la Fouchardière,
  • Denis Smith,
  • François Ghiringhelli,
  • Angélique Vienot,
  • Marion Jacquin,
  • Elodie Klajer,
  • Thierry Nguyen,
  • Éric François,
  • Julien Taieb,
  • Karine Le Malicot,
  • Dewi Vernerey,
  • Aurélia Meurisse,
  • Christophe Borg

DOI
https://doi.org/10.1186/s40164-023-00413-2
Journal volume & issue
Vol. 12, no. 1
pp. 1 – 5

Abstract

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Abstract Triplet DCF (docetaxel, cisplatin and 5-flurouracil) and doublet CP/CF (carboplatin and paclitaxel/cisplatin and 5-fluorouracil) regimens were prospectively evaluated in advanced squamous anal cell carcinoma (SCCA), and validated as standard treatments. Even though the high efficacy and good tolerance of DCF regimen were confirmed in 3 independent prospective trials, doublet CP regimen is still recommended in several guidelines based in its better safety profile with similar efficacy compared to CF regimen. We performed a propensity score-adjusted method with inverse probability of treatment weighted (IPTW) and matched case control (MCC) comparison among patients with metastatic or non-resectable locally advanced recurrent SCCA, treated with chemotherapy as first line regimen. The primary endpoint was the overall survival (OS), and the secondary endpoint was the progression-free survival (PFS). 247 patients were included for analysis. 154 patients received DCF and 93 patients received a doublet regimen. The median OS was 32.3 months with DCF and 18.3 months with doublet regimens (HR 0.53, 95%CI 0.38–0.74; p = 0.0001), and the median PFS was 11.2 months with DCF versus 7.6 months with doublet regimens (HR 0.53, 95%CI 0.39–0.73; p < 0.0001). The hazard ratios by IPTW and MCC analyses were 0.411 (95% CI, 0.324–0.521; p < 0.0001) and 0.406 (95% CI, 0.261–0.632; p < 0.0001) for OS, and 0.466 (95% CI, 0.376–0.576; p < 0.0001) and 0.438 (95% CI, 0.298–0.644; P < 0.0001) for PFS. The triplet DCF regimen provides a high and significant benefit in OS and PFS over doublet regimens, and should be considered as upfront treatment for eligible patients with advanced SCCA.

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