New Breakthroughs in Rare Cancers: Developments in Anal ...

New Breakthroughs in Rare Cancers: Developments in Anal Cancer in the

Last 12 Months

Cathy Eng, MD, FACP, FASCO Professor of Medicine, Hematology and Oncology

Co-Director, GI Oncology Co-Leader, Gastrointestinal Cancer Research Program

July 6, 2019

Contact Info: cathy.eng@ Twitter: @cathyengmd

Disclosures

? Grants ? Advaxis ? Bristol Myers Squibb ? Forty-seven Inc. ? Genentech/Roche

? Advisory Boards ? Advaxis ? Bayer ? EMD-Serono ? Forty-Seven ? Genentech/Roche ? Hutchinson ? LSK ? Sirtex ? Taiho

Discussion Points

? Incidence ? Prior treatment guidelines ? New immunotherapeutic developments ? Changes in treatment guidelines ? Ongoing/Developing Clinical Trials

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Incidence of Anal Cancer in 2019

o Over 35,000 new cases annually of anal cancer are diagnosed worldwide. o New anal cancer cases have been rising on average 2.2% each year over the last 10 years. Death rates

have been rising on average 2.9% each year over 2006-2015.

; St. Laurent et al: Curr Probl Cancer, 2018: Siegel et al: CA Cancer Clin, 2019

Salient Facts of Anal Cancer

? SCCA is associated with HPV > 90% of all cases ? The majority of patients will present with early stage disease and will be treated

with concurrent chemoXRT with sphincter preservation and curative intent. ? Risk factors for residual or recurrent disease include T > 4 cm and N+

? Metastatic disease will develop in < 20% of patients

? Historically prior to 2018, no well established chemotherapy regimen for metastatic pts ? 5-yr OS = 32%

C. Eng: MD Anderson Manual of Clinical Oncology, 2006; Frisch et al: J Natl Cancer Inst 92:1500-10, 2000; Frisch M, et al: J Natl Cancer Inst 91:708-15, 1999; Eng et al: OncoTarget 2014; ; Gunderson et al, JCO, 2012.

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