Managing Patients With Early Stage Anal Carcinoma

Charles J. Schneider, MD, FACP, a clinical professor of Medicine at the Abramson Cancer Center at Perelman Center for Advanced Medicine, discusses the ways in which the management and care of patients with anal carcinoma has changed over the past decade.

According to Schneider, the treatment of patients with early disease anal carcinoma unfortunately has not been majorly modified since the 1980s due to the consistently high cure rates seen with chemotherapy and radiation in these patients.

Now, immunotherapy and targeted therapies have been brought front and center as treatment options for patients with anal carcinoma as advancements have occurred in the field. Some of these advancements include 2 PD-1 inhibitors, nivolumab (Opdivo), and pembrolizumab (Keytruda). Nivolumab and pembrolizumab have become the standard of care for patients with advanced disease who are resistant to chemotherapy.

Transcription:

0:08 | Our treatment for early disease, and this sounds kind of horrible, but it really has not changed much at all since the 1980s. The reason is because nothing has been found to be better than the chemotherapy and radiation that we use for early-stage disease with very high cure rates. The only thing new really in local disease is 2 things. The first is that more patients are being treated now with an oral chemotherapy drug as a substitute for 1 of the 2 [intravenous] drugs with radiation with comparable cure rates. Then the second is that we are investigating immunotherapy as a component of treatment for localized disease as well, for advanced disease.

1:00 | Immunotherapy and targeted therapy has come to the forefront. You know, especially with the PD-1 inhibitors of a drug called nivolumab and a drug called pembrolizumab, which have become our standard of care for patients who were resistant to chemotherapy in advanced disease.