Triplet Chemotherapy with Cisplatin, Ifosfamide and 5-Fluorouracil in Advanced Anal Cancer. A Population Based Retrospective Analysis from the Danish Anal Cancer Group

Background:
Squamous Cell Carcinoma of the Anus (SCCA) is a relatively rare malignancy with an annual incidence in the
Western world of 0.5-1.7 per 100,000 citizens. Because of the low incidence, which is even lower when it comes to advanced
disease, the knowledge on treatment options and clinical effect is limited.
Combination treatment with carboplatin and paclitaxel or cisplatin and 5-fluorouracil is internationally recommended as first-
line treatment of metastatic or inoperable SCCA. However, complete remission is rare and the prognosis poor with a median
survival of approximately 12 months. The combination of cisplatin, ifosfamide and 5-fluorouracil (CILF) represents an inten
-sified treatment option and has been used for advanced SCCA in Denmark for several years, but its efficacy has not yet been
evaluated, which was the aim of the present study.
Methods:
We conducted a retrospective population-based study of all patients treated with palliative CILF for metastatic or
inoperable recurrent SCCA in Denmark between October 2003 and October 2019 using Danish Hospital Registries.
Results:
A total of 48 patients met the eligibility criteria. Median age at diagnosis was 57.4 years (range 41-75). The overall
response rate was 39.6% (19 patients) of which 6.3% (three patients) had a complete response. Median progression-free and
overall survival was 7.2 months (95% CI 3.4-8.6) and 13.3 months (95% CI 10.4-16.3), respectively.
Conclusion:
This retrospective analysis reports a three-drug regimen with no added value compared to that of the standard
regimens with cisplatin + 5-FU or carboplatin + paclitaxel.