What’s New in Laryngeal and Hypopharyngeal Cancer Research and Treatment?

Research into the causes, prevention, and treatment of laryngeal and hypopharyngeal cancers is now being done at many medical centers, university hospitals, and other institutions around the world.

Gene changes in laryngeal and hypopharyngeal cancers

A lot of research is being done to learn how changes in certain genes cause cells in the larynx or hypopharynx to become cancer. As doctors learn more about these gene changes, it could help them better identify which cancers are going to be harder to treat or are more likely to come back after treatment.

Researchers hope this information might also lead to better tests for early detection and to new treatments.

Treatment

In the coming years, promising new forms of treatment may work better and cause fewer long-term treatment-related changes in how a person eats and speaks.

Surgery

Doctors continue to improve surgery techniques to limit the amount of normal tissue that's removed along with the tumor. This might help lessen side effects after treatment.

One surgery technique now being studied is transoral robotic surgery (TORS). In this approach, the surgeon operates by precisely moving robotic arms holding long surgical tools that are passed down the throat. TORS uses smaller incisions (cuts), so it might lessen the side effects and long-term changes from surgery. Doctors are looking at using TORS instead of more extensive open surgery for early-stage tumors.

Transoral videolaryngoscopic surgery or TOVS is another surgical method that might prove helpful in removing small tumors and saving healthy tissue. In TOVS, the surgery is done using a scope that's put in through the mouth. The doctor looks into the scope to see inside and uses long, thin tools to take out the tumor.

Chemotherapy and chemoradiotherapy

New combinations of chemotherapy and immunotherapy drugs are being studied with different radiation techniques, schedules, and doses to find a better tolerated and/ more effective treatment approach than the standard chemoradiation. You may ask your doctor if there are any clinical trials that are appropriate for you.

Targeted therapy

Targeted therapy drugs attack specific genes and proteins in or around cancer cells that help them grow. These drugs work differently from standard chemotherapy drugs because they target cancer cells and cause less damage to normal cells. They may work in some cases when chemo drugs don't, and they often have different side effects. Targeted therapies are used to treat many kinds of cancer. Studies are looking at whether they might help treat laryngeal and hypopharyngeal cancers, too.

EGFR inhibitors: Squamous cell cancers of the larynx and hypopharynx (and other head and neck cancers) often have abnormally high levels of the epidermal growth factor receptor (EGFR) protein. EGFR helps the cancer cells grow out of control. Drugs that block EGFR, such as cetuximab, can slow cancer cell growth. Cetuximab (Erbitux) is approved for use in some head and neck cancers, and several other EGFR inhibitors are now being studied. Cetuximab is also being studied in combination with other targeted drugs or with immunotherapy drugs. These drugs seem to work best when combined with other treatments, like radiation and chemotherapy.

Immunotherapy

Immunotherapy is the use of medicines that help a person’s own immune cells find and destroy cancer cells. It can be used to treat some people with laryngeal or hypopharyngeal cancer.

The immunotherapy drugs, pembrolizumab and nivolumab, can be used in people whose laryngeal or hypopharyngeal cancers have spread or have come back after chemoradiation. Studies are now looking to see if these drugs alone or used along with chemotherapy might be used upfront with surgery or radiation to treat early-stage cancers.