What’s New in Oral Cavity and Oropharyngeal Cancer Research?

Research on oral and oropharyngeal cancers is taking place in many university hospitals, medical centers, and other institutions around the world. Each year, scientists find out more about what causes these diseases, how to prevent them, and how to better treat them. Most experts agree that treatment in a clinical trial should be considered for any type or stage of cancer in the head and neck areas. This way people can get the best treatment available now and may also get the new treatments that are thought to be even better. The new and promising treatments discussed here are only available in clinical trials.

DNA changes

A great deal of research is being done to learn about the DNA changes that cause the cells in the oral cavity and oropharynx to become cancer.

One of the changes often found in DNA of oral cancer cells is a mutation of the TP53 gene. The protein produced by this gene (called p53) normally helps keep cells from growing too much and helps to destroy cells that are too damaged to be fixed. Changes in the TP53 gene can lead to increased growth of abnormal cells and cancer.

Some studies suggest that tests to find these gene changes might help find oral and oropharyngeal cancers early. These tests may also be used to better find cancer cells that might have been left behind after surgery and to determine which tumors are most likely to respond to chemo or radiation therapy. The use of p53 gene therapy as a treatment for these cancers is also being studied in early phase clinical trials.

Discoveries about how changes in the DNA of cells in the mouth and throat cause these cells to become cancer are also being applied to experimental treatments intended to reverse these changes. Another type of gene therapy boosts the immune system so it can better find and kill cancer cells. These forms of treatment are still in very early stages of study, so it will be several years before we know if any of them are effective.

Prevention

Some studies are looking at drugs that might help prevent oral cavity and oropharyngeal cancers in people at high risk for them, such as those with pre-cancerous conditions or a history of one of these cancers. Erlotinib (Tarceva®), a drug that keeps the epidermal growth factor receptor (EGFR) from signaling cells to grow, is one drug being tested. Metformin, a drug already used to treat diabetes, is also under study. This drug may help keep pre-cancerous changes from turning into cancers.

Several other types of drugs are now being tested to help prevent these cancers. Some early research has found that certain extracts of black raspberries might even help prevent these cancers. All of these drugs and compounds need further study.

Treatment

Oral cavity and oropharyngeal cancers that are linked with HPV tend to have a better outcome than those that are HPV negative (HPV-). Clinical trials are starting to look at these HPV+ and HPV- cancers separately. For instance, studies are being done to see if HPV+ cancers can be treated with less chemo and radiation without reducing survival. Researchers are also working on treatments aimed at HPV infections or that target HPV-infected cancer cells. Studies are also looking for better ways to treat HPV- cancers, too, as well as the best ways to use the treatments we already have.

A great deal of research is focusing on improving results from chemotherapy (chemo) for people with these cancers. This includes figuring out which combinations of drugs work best and determining how best to use these drugs along with other forms of treatment. Researchers also continue to develop new chemo drugs that might be more effective against advanced oral and oropharyngeal cancers. They're also looking at whether drugs approved to treat other kinds of cancer might work for these cancers.

Doctors are always looking at newer ways of focusing radiation on tumors more precisely to help them get more radiation to the tumor while limiting side effects to nearby areas. This is especially important for head and neck tumors like oral cavity and oropharyngeal cancers, where there are often many important structures very close to the tumor.

Clinical trials are studying targeted therapies that might block the action of substances (such as growth factors and growth factor receptors) that cause head and neck cancers to grow and spread. Drugs that target the epidermal growth factor receptor (EGFR) may help treat oral and oropharyngeal cancers. For example, the drug erlotinib (Tarceva®) has shown promising results in early phase trials. Drugs that block the growth of blood vessels tumors need to survive, such as bevacizumab (Avastin®), are now being studied for use against these cancers as well.

PDT or photodynamic therapy involves using a drug that the cancer cells absorb. The drug is then exposed to a special light which "turns it on" so it kills the cancer cells. This treatment has been used since the 1980s, but there's been a renewed research interest in how it might be used to treat oral and orophayngeal cancers. PDT is less damaging than surgery, and because there are many important structures very close to these tumors, it might be useful in early stage cancers and those that come back (recur) after treatment.

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.

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Last Medical Review: March 9, 2018 Last Revised: March 9, 2018

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