Carboplatin-paclitaxel With Retifanlimab or Placebo in Participants With Locally Advanced or Metastatic Squamous Cell Anal Carcinoma (POD1UM-303/InterAACT 2).

Prior treatment

• Has received prior PD-(L)1 directed therapy
• Has received prior radiotherapy with or without radiosensitizing chemotherapy within 28 days of Cycle 1 Day 1 except for palliative radiation (30 Gy or less) which is restricted for 14 days of Cycle 1 Day 1 (note: all toxicities associated should have resolved to Grade ≤ 1).
• Receipt of a live vaccine within 28 days of planned start of study therapy.
• Current use of protocol defined prohibited medication.

Other illness

• History of second malignancy within 3 years (with exceptions).
• Clinically significant pulmonary, cardiac, gastrointestinal or autoimmune disorders.
• Active bacterial, fungal, or viral infections, including hepatitis A, B, and C and IV antibiotic use within 7 days of Cycle 1 Day 1.
• History of organ transplant, including allogeneic stem cell transplantation.
• Known hypersensitivity to platinum, paclitaxel, another monoclonal antibody, or any of the excipients that cannot be controlled with standard measures (eg, antihistamines, corticosteroids).

Lab values

• Participants with laboratory outside of the protocol defined ranges.

Other

• Known active CNS metastases and/or carcinomatous meningitis.
• Participant is pregnant or breastfeeding.
• Has pre-existing peripheral neuropathy that is ≥ Grade 2 by CTCAE v5.
• Inability or unlikely, in the opinion of the investigator, to comply with the Protocol requirements

• Able to comprehend and willing to sign a written ICF for the study.
  • Are 18 years of age or older (or as applicable per local country requirements).
  • Histologically or cytologically verified, inoperable locally recurrent or metastatic SCAC.
  • No prior systemic therapy other than the following: a. Chemotherapy administered concomitantly with radiotherapy as a radiosensitizing agent is permitted.
  • Prior neoadjuvant or adjuvant therapy if completed ≥ 6 months before study entry.
  • Has measurable disease per RECIST v1.1 as determined by local site investigator/radiology assessment. Tumor lesions situated in a previously irradiated area, or in an area subjected to other loco-regional therapy, are usually not considered measurable unless there has been demonstrated progression in the lesion.
  • Able and willing to provide adequate tissue sample and whole blood sample with central testing result prior to randomization. Biopsy for archival samples should have occurred within 9 months prior to randomization.
  • ECOG performance status 0 to 1.
  • If HIV-positive, then must be stable as defined by: a. CD4+ count ≥ 200/μL, b. Undetectable viral load per standard of care assay, c. Receiving antiretroviral therapy (ART/HAART) for at least 4 weeks prior to study enrollment, and have not experienced any HIV-related opportunistic infection for at least 4 weeks prior to study enrollment.
  • Willingness to avoid pregnancy or fathering children