Anal Cancer — SCE Medical Oncology MCQ

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ModerateGI CancersAnal CancerSCE Medical Oncology

A 55-year-old woman with advanced anal squamous cell carcinoma (stage IV with liver metastases) is starting first-line systemic therapy. What is the recommended regimen based on the InterAACT trial?

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Correct answer: D — Carboplatin + paclitaxel

The InterAACT trial established carboplatin + paclitaxel as the preferred first-line regimen for metastatic anal SCC, demonstrating a more favourable toxicity profile and similar efficacy compared with cisplatin + 5-FU. Pembrolizumab (KEYNOTE-158) and nivolumab (CheckMate 358) have demonstrated activity in second-line after platinum failure. For localised anal cancer, definitive chemoradiotherapy (mitomycin C + 5-FU + 50.4 Gy) remains the standard curative treatment.

Reference: ESMO 2024 Anal Cancer Guidelines; InterAACT Rao et al Lancet Gastroenterol Hepatol 2020