| Line | All comers |
|---|
| Early / localised | 1 |
| Advanced, first line | 1 |
| Second line | 1 |
| Third line and beyond | 1 |
| Other settings | 1 |
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|
| All comers | Localised (stage I-III) | Definitive IMRT chemoradiation with concurrent mitomycin + 5-FU (or capecitabine); small T1 perianal lesions may be excised; assess response at 26 weeks before declaring failure (ACT II). | | NCCN · Category 1 (5-FU/mitomycin + RT) | 93 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|
| All comers | Metastatic, first line | Retifanlimab + carboplatin-paclitaxel (POD1UM-303, PFS and OS benefit); carboplatin-paclitaxel alone if immunotherapy contraindicated. | | NCCN · Category 1 | 82 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|
| All comers | Persistent or recurrent local disease | Salvage abdominoperineal resection with permanent colostomy; flap reconstruction. | | | 40 |
Third line and beyond
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|
| All comers | Metastatic, later lines | Nivolumab or pembrolizumab if not previously given; clinical trials. | | NCCN · Category 2A | 98 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|
| All comers | Precancer (HSIL) in people with HIV | Screening with anal cytology / high-resolution anoscopy and treatment of HSIL (ablation, topical therapy) reduces progression to cancer by 57% (ANCHOR). | | ANCHOR (NEJM 2022) | 90 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.