CCS adapting to COVID-19 realities to support Canadians during and after the pandemic
Research in head and neck cancer
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better ways to treat head and neck cancer. The following is a selection of research showing promise for treating head and neck cancer.
We’ve included information from the following sources. Each item has an identity number that links to a brief overview (abstract).
- PubMed, US National Library of Medicine (PMID)
- Canadian Cancer Trials and ClinicalTrials.gov (NCT)
Researchers are looking for the best ways to treat head and neck cancer using surgery. They want to find new ways of doing surgery that cause less injury to the body (called minimally invasive surgery) and fewer problems (complications).
Transoral robotic surgery and transoral laser microsurgery use either a surgical robot or a laser with an endoscope to remove head and neck tumours through the mouth. Researchers are studying these treatments mainly for oropharyngeal cancers. They want to find out if they work better and cause fewer side effects than more invasive surgeries or other treatments such as chemotherapy and radiation (The Journal of Craniofacial Surgery, PMID 30480635; Oral Oncology, PMID 30409323; The Laryngoscope, PMID 30152175).
Find out more about research in cancer surgery.
Researchers are looking for ways to improve radiation therapy as a treatment for head and neck cancer.
Proton therapy is a type of external radiation therapy that uses proton beams (positively charged particles) instead of x-ray beams to destroy cancerous tissue. X-ray beams release energy before and after they hit their target. Proton beams are different because they release most of their energy after travelling a certain distance. As a result, proton beams cause very little damage to tissues that they pass through and more radiation can be delivered to the tumour. Researchers are studying the use of proton therapy to treat head and neck cancer, particularly cancer that comes back after it has been treated with radiation (Current Treatment Options in Oncology, PMID 29744681; Radiation Oncology, PMID 27639891; Journal of Cancer Research and Clinical Oncology, PMID 26521257; ClinicalTrials.gov, NCT 01893307).
Stereotactic body radiation therapy (SBRT) delivers precisely targeted high doses of radiation to tumours in difficult or hard-to-reach areas in fewer sessions than standard external radiation therapy. It lowers the harmful effects (toxicities) of radiation on healthy tissue. Researchers are looking at using SBRT to give radiation again (reirradiation) for head and neck cancer that has come back after standard external radiation therapy. Early studies show SRBT may be help control the cancer and improve survival, but randomized clinical trials are needed to confirm these results (Head and Neck, PMID 29684256; Critical Reviews in Oncology/Hematology, PMID 29373181; International Journal of Radiation Oncology, Biology, Physics, PMID 25680594).
Find out more about research in radiation therapy.
The following is noteworthy research in chemotherapy for head and neck cancer.
Induction chemotherapy is given as the first treatment and followed by other treatments. Researchers are trying to find out if induction chemotherapy followed by chemoradiation is better than chemoradiation alone in treating head and neck cancer (Annals of Oncology, PMID 28911070; European Journal of Cancer, PMID 28214653; Radiotherapy and Oncology, PMID 26589131).
Metronomic chemotherapy gives smaller doses of a drug over a longer period of time, which can help lower side effects while controlling the cancer. Researchers are studying metronomic chemotherapy for head and neck cancer that has come back after treatment. Research shows that metronomic chemotherapy may be a treatment option for advanced head and neck cancer, especially when other treatments haven’t worked (Indian Journal of Cancer, PMID 29199656; Medicine, PMID 28403082).
New chemotherapy drugs that show promise in treating head and neck cancer include:
- S-1 (PLoS One, PMID 29883463, PMID 25671770)
- valproic acid (Depakene, Epival) (BMC Cancer, PMID 27884140)
Find out more about research in chemotherapy.
Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer.Researchers are studying the following types of immunotherapy for head and neck cancer.
Immune checkpoint inhibitors are types of immunotherapy drugs called monoclonal antibodies. The immune system normally stops itself from attacking normal cells in the body by using specific proteins called checkpoints, which are made by some immune system cells. Head and neck cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors are drugs that work by blocking these checkpoint proteins so immune system cells (called T cells) can attack and kill the cancer cells. Researchers are studying the following immune checkpoint inhibitors for head and neck cancer:
- pembrolizumab (Keytruda) (Journal of Clinical Oncology, PMID 28328302; Canadian Cancer Trials, NCT 03040999)
- atezolizumab (Tecentriq) (Canadian Cancer Trials, NCT 03452137)
- avelumab (Bavencio) (Future Oncology, PMID 30461306; Canadian Cancer Trials, NCT 02952586)
Find out more about research in immunotherapy.
Targeted therapy drugs target specific molecules (usually proteins) that cause cancer cells to grow. The following targeted therapy drugs are showing promise in treating head and neck cancer.
PI3K (phosphoinositide 3-kinase) inhibitors work by switching off PI3K, which is an enzyme that makes cells grow and divide. Researchers are looking at PI3K inhibitors, such as buparlisib, for treating head and neck cancer (Lancet Oncology, PMID 28131786).
mTOR inhibitors work by blocking mTOR, which is a protein that regulates cellular metabolism and growth and how quickly cells multiply. Researchers are looking at the following mTOR inhibitors for treating head and neck cancer:
- everolimus (Afinitor) (Head and Neck, PMID 27232378; Annals of Oncology, PMID 26025965)
- temsirolimus (Torisel) (Annals of Oncology, PMID 28961834, PMID 25527417)
Tyrosine kinase inhibitors are drugs that block the enzyme tyrosine kinase, which helps cells develop and grow. Researchers are looking at the following tyrosine kinase inhibitors in treating head and neck cancer:
- afatinib (Giotrif) (Annals of Oncology, PMID 27084954; Oral Oncology, PMID 26705063)
- dacomitinib (Vizimpro) (Expert Opinion on Investigational Drugs, PMID 2700370; American Journal of Clinical Oncology, PMID 26967327)
- erlotinib (Tarceva) (Head and Neck, PMID 26918562; Clinical Oral Investigations, PMID 26297130)
- gefitinib (Iressa) (Cancer Biology and Therapy, PMID 25756517; Head and Neck, PMID 24585506)
- lapatinib (Tykerb) (Journal of Clinical Oncology, PMID 26527790)
Monoclonal antibodies block a target (often a protein) on the outside of a cancer cell. They do this by recognizing and locking onto the protein so that it can’t do its job. Panitumumab (Vectibix) is a monoclonal antibody that attaches to epidermal growth factor receptor (EGFR) proteins on cancer cells. Researchers are looking at panitumumab as a treatment for head and neck cancer (The Oncologist, PMID 28592616; European Journal of Cancer, PMID 28040660).
Researchers are looking at the following as possible treatments for head and neck cancer.
Photodynamic therapy (PDT) destroys cancer cells using a drug called a photosensitizer, which makes them very sensitive to laser light. The laser light sources usually can’t pass through more than a few millimetres of tissue, so PDT is mainly used to treat areas on or just under the skin, or in the lining of some internal organs. Researchers are studying PDT in treating head and neck cancer (Journal of Investigative and Clinical Dentistry, PMID 28480637; Oral Oncology, PMID 26865261; Photodiagnosis and Photodynamic Therapy, PMID 26072296, PMID 25917042).
Low-level laser therapy uses a low-power laser to remove tissue. Researchers are studying low-level laser as an alternative to radiation therapy to prevent sore mouth (mucositis), which is a common side effect of chemoradiation (Oral Oncology, PMID 26559740).
Radiofrequency and microwave ablation uses high-frequency electrical waves to create heat to destroy cancer cells. It may be a promising alternative treatment to standard therapy for recurrent or advanced head and neck cancers (Journal of Vascular and Interventional Radiology, PMID 26210246).
Learn more about cancer research
Researchers continue to try to find out more about head and neck cancer. Clinical trials are research studies that test new ways to treat head and neck cancer. They also look at ways to prevent, find and manage cancer.
Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for head and neck cancer were first shown to be effective through clinical trials.
A thin, tube-like instrument with a light and lens used to examine or treat organs or structures in the body.
An endoscope can be flexible or rigid. It may have a tool to remove tissue for examination. Specialized endoscopes may have tools designed to examine or treat specific organs or structures in the body.
Specialized endoscopes are named for the organ or structure they are used to examine or treat.
Referring to a procedure or device that breaks the skin or enters a body cavity.
Referring to a disease (such as cancer) that is growing into surrounding tissue or has spread outside the tissue where it started.
A type of radiation therapy that uses a machine outside the body to direct a beam of radiation through the skin to a specific part of the body, usually a tumour.
Also called external beam radiation therapy.
Determined completely by chance.
For example, participants in a randomized clinical trial are randomly assigned to either the control group (those who do not receive the new way to prevent, detect, treat or manage the disease that is being studied) or the experimental group (those who receive the new way to prevent, detect, treat or manage the disease).
Randomization refers to the process of randomly assigning participants to either the control or experimental group.
Treatment that combines chemotherapy with radiation therapy. Chemotherapy is given during the same time period as radiation therapy. Some types of chemotherapy make radiation therapy more effective.
Also called chemoradiotherapy.
A substance that can find and bind to a particular target molecule (antigen) on a cancer cell.
Monoclonal antibodies can interfere with a cell’s function or can be used to carry drugs, toxins or radioactive material directly to a tumour.
A protein that speeds up certain chemical reactions in the body.
For example, enzymes in the intestines help to digest food.