Immunotherapy for Laryngeal Cancer
Laryngeal cancer is a difficult cancer to treat. In fact, the standard treatment of radiation and chemotherapy, or CRT, for the early stages of this cancer of the voicebox is highly toxic and can make things worse. Out of the 24 cancers monitored by the national cancer surveillance program known as SEER, laryngeal cancer that has spread beyond the earliest stage is the only cancer in which the percentage of patients who survive at least five years has been decreasing.
That's one reason many researchers hope that immunotherapy, also called biologic therapy or biotherapy, may offer an alternative. Immunotherapy gets your immune system involved in treating cancer by stimulating it to work harder at fighting and destroying the cancer. It is generally less toxic than chemotherapy, although it can cause symptoms such as chills and fever, nausea, and rashes, as well as more serious side effects.
The most widely used form of immunotherapy to treat cancer is called monoclonal antibodies. This immunotherapy uses antibody proteins that bind to a specific target, such as cancer cells, and leave most healthy tissues alone. It is usually developed in a lab and often injected into the patient.
Immunotherapy for cancer of the larynx
One type of monoclonal antibody that has been specifically studied for laryngeal cancer is known as cetuximab (Erbitux), a drug given by injection.
Sometimes, cetuximab is given along with radiation therapy as a first-line treatment for advanced laryngeal cancers such as squamous cell carcinoma. Other times, it may be tried as an option when other cancer therapies have not been successful.
In a recent phase 3 clinical trial involving advanced laryngeal cancer, as well as other similar types of cancer that had not spread beyond the lymph nodes, 424 patients were placed into groups receiving either radiation therapy alone or radiation therapy plus cetuximab for six to seven weeks. The patients who received both radiation and cetuximab did much better than the patients who received radiation alone. In fact, after five years of monitoring, the group that received the cetuximab had a significantly higher cancer survival rate than the group that did not receive this immunotherapy.
One of the most interesting side notes of this study was that the patients who got a worse rash as a side effect from the cetuximab also had better survival rates than those who had a milder rash or had no rash at all. This suggests that the rash may serve as an indicator that the immunotherapy is effective.
In this particular study, cetuximab was so effective for treating laryngeal cancer in combination with radiation therapy that the researchers concluded that immunotherapy is an important treatment option for patients with advanced laryngeal cancer.
The FDA recently approved cetuximab in combination with other therapies for the treatment of recurrent or spreading head and neck cancers. The FDA had already approved this immunotherapy in conjunction with radiotherapy for local head and neck cancers, and head and neck cancers that have spread to surrounding lymph nodes.
In its latest approval, the FDA noted that the drug may be toxic to the heart and may cause sudden death. The agency recommended that health care providers carefully monitor blood levels of electrolytes, magnesium, calcium, and potassium in patients using cetuximab.
If you have laryngeal cancer, discuss cetuximab immunotherapy with your doctor. You may also want to consider participating in a clinical trial of other types of immunotherapy for your cancer.