Neoplasms of the Anus

Overview Squamous cell carcinoma of the anal canal (SCCA) is a rare human papillomavirus (HPV)‐related malignancy, but with rising incidence in the last decade. Chemoradiotherapy (CRT) remains the cornerstone of the treatment of non‐metastatic disease, characterized by remarkable response rates of 90% and 5‐year overall survival (OS) of 80%. Nevertheless, despite the high efficacy observed with combined modality treatment, almost half of the patients with locally advanced disease have high‐risk features (T3, T4, or node‐positive disease) for treatment failure. The management of unresectable recurrences or metastatic disease is an unmet clinical need, marked by poor clinical outcomes. Immune checkpoint inhibitors and immunotherapeutic approaches have been demonstrating promising results in the management of advanced disease in the past few years, but big steps forward will only be taken when the underutilized HPV vaccination becomes more widely accepted for use.