Advances in anal cancer treatment: current standards, the role of immunotherapy and emerging strategies

Squamous-cell carcinoma of the anus (SCCA), primarily driven by human papillomavirus infection, has seen limited treatment advancements, with current options mainly comprising chemoradiotherapy for localized disease and chemotherapy for advanced cases. However, the rise of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has opened new therapeutic avenues for this rare malignancy. This review explores the current standard of care and the evolving role of immunotherapy in managing SCCA. We discuss the results of key clinical trials, including findings from anti-Programmed cell death protein 1 (anti-PD-1)/anti-Programmed death-ligand 1 (anti-PD-L1) therapies, and ongoing research efforts focused on identifying predictive biomarkers for treatment response. Despite challenges, immunotherapy offers significant promise for improving outcomes in patients with advanced and recurrent anal cancer, potentially transforming the standard of care.