Treatment options in metastatic squamous cell carcinoma of the anal canal

Squamous cell carcinoma of the anal canal is a rare malignancy that is often cured with the combined modality therapy of chemoradiation. Yet, a minority of patients will develop distant metastatic disease, an area of oncology in which a universally accepted approach has not been determined. Consideration of platinum-based systemic chemotherapy is commonly provided for palliation with the optimal duration of therapy being largely unknown; the role of biologics and/or surgical resection of metastatic disease are anecdotal. Patients with no contraindications to systemic chemotherapy should be treated aggressively with consideration of multidisciplinary management if appropriate. Here, we present a summary of the existing literature in the treatment of metastatic anal carcinoma in the hopes of providing insight and potential treatment alternatives for the practicing physician.