Authors
Tamotsu Sagawa, Masahiro Hirakawa, Hiroyuki Nagashima, Koshi Fujikawa
Published in
Journal of gastrointestinal cancer. Volume 57. Issue 1. Oct 28, 2026. Epub Oct 28, 2026.
Abstract
Advanced anal squamous cell carcinoma (ASCC) is a rare human papillomavirus-associated malignancy with historically limited prospective evidence for systemic therapy. InterAAct established carboplatin-paclitaxel as a clinically favorable chemotherapy backbone compared with cisplatin-fluorouracil. POD1UM-303/InterAACT-2 subsequently showed that adding retifanlimab significantly improved progression-free survival in patients with no prior systemic therapy for advanced disease. At the final overall-survival analysis, median overall survival was 32.8 versus 22.2 months (HR 0.75, 95% CI 0.55-1.01); the regimen has received regulatory authorization in the United States, the European Union, and Japan. EA2176 is evaluating carboplatin-paclitaxel with or without nivolumab and will clarify whether first-line PD-1-based chemoimmunotherapy represents a reproducible class effect. This focused narrative review critically summarizes the evidence for retifanlimab- and nivolumab-based strategies and proposes a practical framework for treatment selection. Key considerations include performance status, immune-checkpoint-inhibitor eligibility, HIV infection, autoimmune risk, neuropathy, organ function, tumor burden, local symptom control, and post-chemoimmunotherapy sequencing. Retifanlimab plus carboplatin-paclitaxel currently has the most mature phase III evidence, whereas nivolumab-based chemoimmunotherapy remains investigational pending EA2176. Treatment decisions should distinguish phase III-validated options from class-effect extrapolation and integrate multidisciplinary local therapy when appropriate.
PMID:
42955180
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.
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