Management of Metastatic Anal Cancer

Joseph Do Woong Choi; Devansh Shah; Toufic El-Khoury; Nimalan Pathma-Nathan; James Wei Tatt Toh

doi:10.1016/j.soc.2024.08.001

Management of Metastatic Anal Cancer

Surg Oncol Clin N Am. 2025 Jan;34(1):69-81. doi: 10.1016/j.soc.2024.08.001. Epub 2024 Sep 10.

Authors

Joseph Do Woong Choi¹, Devansh Shah², Toufic El-Khoury³, Nimalan Pathma-Nathan¹, James Wei Tatt Toh⁴

Affiliations

¹ Department of Colorectal Surgery, Westmead Hospital, Sydney, New South Wales 2145, Australia; Discipline of Surgery, Faculty of Medicine and Health, University of Sydney, New South Wales 2000, Australia.
² Department of Colorectal Surgery, Westmead Hospital, Sydney, New South Wales 2145, Australia; Western Sydney University, School of Medicine, New South Wales 2560, Australia.
³ Department of Colorectal Surgery, Westmead Hospital, Sydney, New South Wales 2145, Australia; Discipline of Surgery, Faculty of Medicine and Health, University of Sydney, New South Wales 2000, Australia; University of Notre Dame, School of Medicine, New South Wales 2010, Australia.
⁴ Department of Colorectal Surgery, Westmead Hospital, Sydney, New South Wales 2145, Australia; Discipline of Surgery, Faculty of Medicine and Health, University of Sydney, New South Wales 2000, Australia. Electronic address: [email protected].

PMID: 39547770
DOI: 10.1016/j.soc.2024.08.001

Abstract

Metastatic squamous cell carcinoma of the anal canal is a rare presentation that is suspected in patients with risk factors such as known primary anal cancer, human papillomavirus/human immunodeficiency virus, immunosuppression, smoking, and receptive anal intercourse. Patients may present with metastasis at the index presentation of anal cancer or metastases may occur following the chemoradiation of the primary tumor. Treatment is focused on systemic therapy with chemotherapy, with the consideration of immunotherapy as second-line therapy. Predictive biomarkers may be able to personalize treatment in the future. Clinical trials of different chemotherapy and immunotherapy combinations are active to improve current management.

Keywords: Anal cancer; Chemotherapy; Immunotherapy; Metastatic; Squamous cell carcinoma.

Publication types

Review

MeSH terms

Anus Neoplasms* / pathology
Anus Neoplasms* / therapy
Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / secondary
Carcinoma, Squamous Cell / therapy
Disease Management
Humans
Immunotherapy / methods
Neoplasm Metastasis