Immunotherapy for Anal Cancer

Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. 

Immune checkpoint inhibitors

An important part of your immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses “checkpoints” or proteins on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. But drugs that target these checkpoints can be used to treat some people with anal cancer.

PD-1, a protein on certain immune cells (called T cells) normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these immunotherapy drugs boost the immune response against cancer cells.

• Nivolumab (Opdivo)
• Pembrolizumab (Keytruda)
• Retifanlimab (Zynyz)
• Cemiplimab (Libtayo)
• Dostarlimab (Jemperli)
• Tislelizumab (Tevimbra)
• Toripalimab (Loqtorzi)

These drugs can be used in people with anal cancer that has spread and worsened after they received at least one type of chemotherapy. Immunotherapy can shrink some tumors or slow their growth.

Retifanlimab can be given with chemo as an initial treatment for patients with anal cancer that has spread . It can also be given alone to certain patients.

These immunotherapy drugs can be given as an intravenous (IV) infusion every 2 to 6 weeks.

Possible side effects of checkpoint inhibitors

Side effects of these drugs can include fatigue, cough, nausea, itching, skin rash, loss of appetite, constipation, joint pain, and diarrhea.

Other, more serious side effects occur less often.

Infusion reactions: Some people have an infusion reaction while getting these drugs. This is similar to an allergic reaction, and can include fever, chills, flushing of the face, rash, itchy skin, feeling dizzy, wheezing, and trouble breathing. It’s important to tell your doctor or nurse right away if you have any of these symptoms while getting these drugs.

Autoimmune reactions: Immunotherapy drugs work by removing one of the defenses of the immune system. Sometimes the immune system starts attacking other parts of the body, causing serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

Report any new side effects to your health care team as soon as possible. If you have serious side effects, your treatment might be stopped and you might be given high doses of corticosteroids to suppress your immune system.