Actively Recruiting
Prospective Randomized Phase III Study Comparing Induction Chemotherapy Modified DCF Followed by Chemoradiotherapy Versus Standard Chemoradiotherapy for Locally Advanced Anal Squamous Cell Carcinoma T3-4 or N1
Led by Federation Francophone de Cancerologie Digestive · Updated on 2025-09-02
310
Participants Needed
114
Research Sites
52 weeks
Total Duration
On this page
Sponsors
F
Federation Francophone de Cancerologie Digestive
Lead Sponsor
F
Fondation ARCAD
Collaborating Sponsor
AI-Summary
What this Trial Is About
Squamous cell carcinoma of the anus is a rare but increasingly common cancer, often linked to human papillomavirus HPV. For early-stage tumors, combined radiotherapy and chemotherapy with 5FU and mitomycin-C provide good outcomes, but advanced tumors have a poor prognosis with a high relapse rate. Researchers are studying a new approach combining induction chemotherapy with docetaxel, cisplatin, and 5FU mDCF followed by standard chemoradiotherapy to improve treatment results for locally advanced anal cancer T3-4 or N1. This is a randomized phase 3 trial comparing this new strategy to the current standard treatment. The study includes two groups one receives the usual chemoradiotherapy, which involves 33 radiotherapy sessions over 6.5 weeks combined with mitomycin-C and capecitabine chemotherapy taken on radiotherapy days. The other group starts with 4 cycles of mDCF chemotherapy given every two weeks before receiving the same chemoradiotherapy as the control group. Radiotherapy uses intensity-modulated external irradiation with a targeted boost to the tumor and involved lymph nodes. Participants will be followed after treatment with check-ups at 8 weeks, then every 4 months for two years, and every 6 months in the third year. Follow-up includes clinical exams and imaging scans CT and MRI. The main measure of success is disease-related event-free survival two years after treatment. Other outcomes include overall survival, colostomy-free survival, treatment side effects, tumor response, and quality of life. The total study duration for each participant may extend over several years including this follow-up period.
CONDITIONS
Brief Title
Phase III Study Evaluating Induction Chemotherapy Followed by Chemoradiotherapy Compared to Standard Chemoradiotherapy for Locally Advanced SCCA
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Histologically confirmed anal squamous cell carcinoma
- Locally advanced tumors without metastases (stage T3 or T4, or stage N1 with any T)
- Age 18 years or older and up to 75 years, or over 75 with a favorable oncogeriatric assessment (G8 score > 14)
- Measurable tumor visible on MRI
- Able to receive both chemotherapy and radiotherapy
- No major comorbidities that prevent treatment
- Adequate blood counts: neutrophils ≥ 1500/mm3, platelets ≥ 100,000/mm3, hemoglobin ≥ 9g/dl
- Adequate kidney function: creatinine clearance ≥ 60 ml/min
- Adequate liver function: AST and ALT ≤ 2.5 times upper limit of normal, total bilirubin ≤ 1.5 times upper limit
- WHO performance status less than 2
- Signed informed consent
- Negative pregnancy test for women of childbearing potential
- Effective contraception for women of childbearing potential and men during and after treatment
- Covered by French Social Security system
You will not qualify if you...
- Presence of metastases
- Early stage tumors (T1N0 or T2N0)
- Previous pelvic radiotherapy
- Complete or partial DPD deficiency
- HIV positive with CD4 count less than 400/mm3
- Neuropathy greater than grade 2
- Contraindications to chemotherapy or radiotherapy
- Concurrent treatment with CYP3A4 inhibitors or inducers
- Symptomatic heart or coronary disease
- Active progressive infection or severe condition in last 6 months
- Contraindication to MRI
- Other cancer treated within last 3 years except certain in situ carcinomas
- Breastfeeding women
- Persons unable to give consent or under guardianship
- Psychological, social, or geographical issues that may affect compliance
- Live attenuated vaccines within 4 weeks before enrollment
- Hearing problems, phenytoin use for prophylaxis, or recent/concomitant brivudine treatment
Research Team
V
Veronique Vendrely, Md-pHD
J
Jérémie BEZ, MS
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