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

Fiche publication

Date publication

juillet 2023

Journal

Experimental hematology & oncology

Auteurs

Membres identifiés du Cancéropôle Est :
Pr BORG Christophe , Pr BOUCHE Olivier , Pr GHIRINGHELLI François , Mme JACQUIN Marion , Dr VERNEREY Dewi , Dr VIENOT Angélique , Dr KIM Stephano , Mme MEURISSE Aurélia

Tous les auteurs :
Kim S, Vendrely V, Saint A, André T, Vaflard P, Samalin E, Pernot S, Bouché O, Zubir M, Desrame J, de la Fouchardière C, Smith D, Ghiringhelli F, Vienot A, Jacquin M, Klajer E, Nguyen T, François É, Taieb J, Le Malicot K, Vernerey D, Meurisse A, Borg C

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/37480095

Résumé

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.