Chemotherapy, “Lighting the Fire” or “Releasing the Brakes” in Metastatic Anal Cancer

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Squamous cell carcinoma of the anus (SCCA) is a rare cancer. Few patients have overt metastatic disease at presentation, and only a small subset of patients subsequently develop it. Locoregional failure leads to the majority of cancer-specific deaths. In the ACT II trial, locoregional failure was the predominant pattern of relapse. Only 209 of 940 (22%) patients in the trial relapsed, and the majority of first recurrences were pelvic alone (64%). Distant metastases were only found in 46 of 209 (22%).
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