OnCo

Anal cancer (squamous cell carcinoma): lines of therapy

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5 standard-of-care settings across 5 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comers
Early / localised1
Advanced, first line1
Second line1
Third line and beyond1
Other settings1

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersLocalised (stage I-III)Definitive IMRT chemoradiation with concurrent mitomycin + 5-FU (or capecitabine); small T1 perianal lesions may be excised; assess response at 26 weeks before declaring failure (ACT II).91

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersMetastatic, first lineRetifanlimab + carboplatin-paclitaxel (POD1UM-303, PFS and OS benefit); carboplatin-paclitaxel alone if immunotherapy contraindicated.81

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersPersistent or recurrent local diseaseSalvage abdominoperineal resection with permanent colostomy; flap reconstruction.40

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
All comersMetastatic, later linesNivolumab or pembrolizumab if not previously given; clinical trials.98

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersPrecancer (HSIL) in people with HIVScreening with anal cytology / high-resolution anoscopy and treatment of HSIL (ablation, topical therapy) reduces progression to cancer by 57% (ANCHOR).89

Regimens in the library

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.