A trial looking at different types of chemotherapy for anal cancer that has spread or come back after treatment (InterAACT)

Cancer type:

Anal cancer

Status:

Results

Phase:

Phase 2

This trial compared cisplatin and 5 fluorouracil (5FU) with carboplatin and paclitaxel for anal cancer. It was for people whose cancer has spread or come back after treatment, and who couldn’t have surgery. It was supported by Cancer Research UK.

This trial was open for people to join between 2013 and 2017, and the team reported the results in 2020.

More about this trial

When anal cancer spreads to another part of the body or comes back after treatment, doctors often treat it with chemotherapy. When this trial was done, they often used a combination of 2 chemotherapy drugs called cisplatin and 5-fluorouracil (5FU).

At the time, doctors used the combination of carboplatin and paclitaxel (Taxol) to treat other types of cancer. Some small studies had shown that these 2 drugs could also help people with anal cancer.

The main aims of this trial were to find out which combination of treatment:

  • is best for anal cancer that has spread
  • has fewer side effects

Summary of results

The research team found that carboplatin and paclitaxel caused fewer side effects, and may help people live longer.

Trial design
The people taking part in this trial had anal cancer that had spread or continued to grow since their last treatment. They were due to have chemotherapy treatment.

A total of 91 people took part. They were put into 1 of 2 treatment groups at random. There were:

  • 46 people in the cisplatin and 5FU group
  • 45 people in the carboplatin and paclitaxel group

Results
The research team were able to look at how well the treatment worked in 74 of the people who took part. They found that the cancer either went away or got a bit smaller in nearly the same number of people in each group:

  • 20 out of 35 people (57%) who had cisplatin and 5FU
  • 23 out of 39 people (59%) who had carboplatin and paclitaxel 

They then looked at how long it was before the cancer started to grow again, and found it was:

  • 5.7 months for those who had cisplatin and 5FU
  • 8.1 months for those who had carboplatin and paclitaxel


And when they looked at how long people lived for, it was:

  • 12.3 months for those who had cisplatin and 5FU
  • 20.0 months for those who had carboplatin and paclitaxel

There was a relatively small number of people in each group, so it’s difficult to say for sure whether the difference between the groups is due to the different treatments. It could have been partly due to chance.

Side effects
The research team were able to assess the side effects of 42 people in each group.

They found that in the group who had cisplatin and 5FU:

  • 32 people had at least 1 side effect
  • 26 of those people had a more serious side effect

And in the group who had carboplatin and paclitaxel:

  • 30 people had at least 1 side effect
  • 15 of those people had a more serious side effect

More people who had cisplatin and 5FU had sickness, a sore mouth or diarrhoea. And more people who had carboplatin and paclitaxel had a drop in red blood cells and white blood cells.

Conclusion
The trial team concluded that carboplatin and paclitaxel causes fewer side effects than cisplatin and 5FU. And that it could help people with advanced anal cancer live longer. 

They recommend that doctors consider using carboplatin and paclitaxel as standard treatment for this group of patients.

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed) Open a glossary item and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.
 

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Sheela Rao

Supported by

Australian Gastro-Intestinal Trials Group (AGITG)
Cancer Research UK 
ECOG-ACRIN Cancer Research Group 
Experimental Cancer Medicine Centre (ECMC)
International Rare Cancers Initiative (IRCI)
NHMRC Clinical Trials Centre (CTC) 
NIHR Clinical Research Network: Cancer
The Royal Marsden NHS Foundation Trust

Other information

This is Cancer Research UK trial number CRUK/12/038.

Freephone 0808 800 4040

Last review date

CRUK internal database number:

10516

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Around 1 in 5 people take part in clinical trials

3 phases of trials

Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.

Last reviewed:

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