What’s New in Laryngeal and Hypopharyngeal Cancers 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 great deal 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 targeted treatments.

Treatment

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

Surgery

Doctors continue to refine surgery techniques to try to limit the amount of normal tissue that's removed along with the tumor. This may help limit 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 also looking at using chemo before TORS to help shrink tumors and maybe save more healthy tissue.

Transoral videolaryngoscopic surgery or TOVS is another surgery method that might prove to be 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 chemotherapy drugs and new combinations of drugs are being tested.

Clinical trials are also studying ways to best combine chemotherapy with radiation therapy. For example, studies are comparing outcomes when chemotherapy is given before, during, and/or after radiation therapy.

Targeted therapy

Newer targeted therapy drugs attack specific substances in or around cancer cells that help them grow. These drugs work differently from standard chemo drugs because they target cancer cells with less damage to normal cells. They may work in some cases when chemo drugs don't, and they often have less severe side effects. Many 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 epidermal growth factor receptor (EGFR). EGFR helps the cancer cells grow out of control. Drugs that block EGFR and slow cell growth are under study for use in head and neck cancers. Some of these drugs include nimotuzumab, pembrolizumab (Keytruda®), nivolumab (Opdivo®), and ipilimumab (Yervoy®).

These drugs seem to work best when combined with other treatments, like radiation and chemotherapy.

Preserving function and quality of life

Doctors are looking at how transplant and tissue grafting might be used to help rebuild the throat area after surgery. This could help improve overall quality of life and limit changes in how people speak and eat.

Researchers are also looking at better ways to support patients with parenteral nutrition so they can better tolerate treatment. (Parenteral nutrition is put into a vein, right into the blood, so the body can get the nutrients it needs when a person can't swallow food.)

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Coskun C, Verim A, Farooqi AA, et al. Are there possible associations between MnSOD and GPx1 gene variants for laryngeal cancer risk or disease progression? Cell Mol Biol (Noisy-le-grand). 2016;62(5):25-30.

Hamilton D, Paleri V. Role of transoral robotic surgery in current head & neck practice. Surgeon. 2017;15(3):147-154.

Hamilton NJI, Birchall MA. Tissue-Engineered Larynx: Future Applications in Laryngeal Cancer. Curr Otorhinolaryngol Rep. 2017;5(1):42-48.

Imanishi Y, Ozawa H, Sakamoto K, et al. Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer. BMC Cancer. 2017;17(1):445.

Li P, Li S, Yang X, et al. Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects. Eur Arch Otorhinolaryngol. 2016;273(12):4391-4396.

Park YM, Keum KC, Kim HR, et al. A Clinical Trial of Combination Neoadjuvant Chemotherapy and Transoral Robotic Surgery in Patients with T3 and T4 Laryngo-Hypopharyngeal Cancer. Ann Surg Oncol. 2017 Oct 30.

Zahoor T, Dawson R, Sen M, Makura Z. Transoral laser resection or radiotherapy? Patient choice in the treatment of early laryngeal cancer: a prospective observational cohort study. J Laryngol Otol. 2017;131(6):541-545.

Last Medical Review: November 27, 2017 Last Revised: November 27, 2017

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