# InterAACT: cisplatin and fluorouracil versus carboplatin and paclitaxel in advanced anal cancer

Source: https://onco.cc/key-papers/paper-interaact-anal-cancer-carboplatin-paclitaxel-jco-2020/  
OnCo record `paper-interaact-anal-cancer-carboplatin-paclitaxel-jco-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The first randomised trial in advanced anal cancer found that carboplatin with paclitaxel shrank tumours about as often as the older cisplatin and fluorouracil combination, with fewer serious side effects and longer survival, and it became the standard first treatment.

## Summary

International Rare Cancers Initiative randomised phase 2 trial of 91 patients with inoperable locally recurrent or metastatic anal squamous cell carcinoma, assigned to cisplatin plus fluorouracil or carboplatin plus weekly paclitaxel.

Objective response rates were similar (about 57 and 59 percent), but serious adverse events were fewer with carboplatin and paclitaxel and median overall survival was 20 months against 12.3 months. Carboplatin and paclitaxel was adopted as the reference first-line regimen and as the chemotherapy backbone for later immunotherapy trials.

## Fields

- Kind: Key paper
- Last checked: 2026-09-18
- Journal: Journal of Clinical Oncology
- Year: 2020
- DOI: 10.1200/JCO.19.03266
- Authors: Rao S, Sclafani F, Eng C, et al.
- Findings: Objective response about 59 percent with carboplatin and paclitaxel versus 57 percent with cisplatin and fluorouracil.; Median overall survival 20 months versus 12.3 months, with fewer serious adverse events.
- What it means: Carboplatin and paclitaxel is the first-line chemotherapy for metastatic anal cancer, and the platform to which PD-1 antibodies such as retifanlimab were added.
- Caveats: Small randomised phase 2 with response as the primary endpoint; the survival difference was a secondary finding.; Accrual took years across many countries, reflecting how rare metastatic anal cancer is.

## Sources

- J Clin Oncol 2020: https://doi.org/10.1200/JCO.19.03266
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32530769/

## Connected records

- cancers: [Metastatic and recurrent anal squamous cell carcinoma](https://onco.cc/cancers/metastatic-anal-cancer/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

---
JSON: https://onco.cc/api/v1/entities/paper-interaact-anal-cancer-carboplatin-paclitaxel-jco-2020.json