Selecting the right chemotherapy in first-line advanced squamous cell carcinoma of the anus

Three different options are available for the treatment of advanced squamous cell carcinoma of the anus (SCCA): or modified docetaxel + cisplatin + 5-fluorouracil (DCF) regimen.1-5 CF was the historical chemotherapy but the prognosis was dismal, the quality of life rapidly compromised during the course of the disease, and no comparative randomized trial comparing these three therapeutic strategies is still available or ongoing. In the recently published European Society for Medical Oncology guidelines for SCCA,1 Rao et al. consider CP as the only standard chemotherapy regimen in metastatic SCCA in first line, based on 39 patients included in the InterAACT The clinical efficacy reported with CP in this study is similar to the results achieved in the control group (CF regimen) and to what was observed historically using CF (15% of patients were free of progression at 12 months, and <20% were still alive at 5 years based on retrospective and of debate, whereas it provides the opportunity to increase tumor responses.