NOTE

🌱 created from: anal cancer

management_refractory_recurrent_and_metastatic_disease_of_anal_cancer

• Confirm progression w/ bx & restaging CT or MRI, consider PET
• If locally progressive,
  • proceed to salvage APR
• For unresectable or metastatic, 1st-line standard Rx includes carbo/paclitaxel (preferred), FOLFCIS, FOLFOX, 5-FU + cis, modified DCF. 2nd line includes nivolumab & pembrolizumab.
  • Modification to dose & schedule may be necessary
• No evidence exists to support metastasectomy in anal CA. Regional Rx in select pts w/ limited dz
• Clinical trial preferred