Given the results of PLATO anal cancer study, is 4140 cGy the new standard for early stage anal cancer?  

The original Nigro regimen using 30 Gy was effective for anal cancer treatment, and so it is not surprising that 41.4 Gy for early stage anal cancer is similarly effective. The Lancet publication is a pre-planned secondary endpoint of cCR, and not the primary endpoint of the trial which is 3-year lo...

Yes, for selected early-stage patients (T1-2 <4 cm, N0, p16+), I will start using de-escalated dosing.  The Lancet Oncology publication demonstrated toxicity results showing better sexual function with de-escalated IMRT (41.4 Gy/23 fxn and 34.5 Gy to LNs)  At ESTRO 2025, the authors p...

ACT IV is an excellent trial, and the results have been long awaited. The completed US-based DECREASE trial through ECOG was in many ways analogous, with a focus on de-escalation for early-stage T1/T2 N0 patients. We are anxiously awaiting the results of this trial as well. There were some slight di...