Targeted and immunotherapy drugs for laryngeal cancer

You might have targeted cancer drugs or immunotherapy as part of your treatment for laryngeal cancer.

What are targeted and immunotherapy drugs for laryngeal cancer?

Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive.

Immunotherapy uses our immune system to fight cancer. It works by helping the immune system recognise and attack cancer cells.

Some drugs work in more than one way. So, they are targeted as well as working with the immune system.

When you might have targeted and immunotherapy drugs for laryngeal cancer

Whether you have targeted therapy or immunotherapy depends on:

• the type of cancer you have
• how far the cancer has grown (the stage)
• what other treatments you can have
• whether your cancer has changes (mutations) in certain proteins

These treatments can help some people with advanced  or locally advanced laryngeal cancer and has come back after previous treatment. They may help to control the cancer for a time.

Tests on your cancer cells

Your doctor might test your cancer cells for particular proteins. This can help to show whether certain drug treatments might work for your cancer. 

To test your cancer cells, your specialist needs a sample (biopsy) of your cancer. They might have tested your cancer cells when you were first diagnosed. Or they might be able to test some tissue from a biopsy or operation you have already had. In some cases, you might need to have another biopsy.

To help decide on treatment for your laryngeal cancer, your doctor may look for large amounts of a protein called PD-L1 (PD-L1 positive cancer). 

Your doctor or specialist nurse will give you more information on your treatment and tests you might have before you start.

Are these drugs available in the UK?

New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage or type of cancer.

Once a drug has a license, several independent organisations approve the new cancer drugs. Only then can doctors prescribe them on the NHS.

Targeted cancer drugs treatment for laryngeal cancer

Cetuximab (Erbitux)

Cetuximab is a type of targeted cancer drug called a monoclonal antibody. 

Monoclonal antibodies work by recognising and finding specific proteins on cancer cells. Different types of cancer have different proteins. The monoclonal antibody stops particular proteins from:

• binding to cancer cells
• blocking the proteins from triggering the cancer cells to divide and grow

You might have cetuximab with radiotherapy if you:

• have locally advanced squamous cell laryngeal cancer
• can't have platinum based chemotherapy (such as cisplatin or carboplatin)

Immunotherapy for laryngeal cancer

Pembrolizumab (Keytruda) 

Pembrolizumab is a type of immunotherapy. It stimulates the body's immune system to fight cancer cells.

Pembrolizumab targets and blocks a protein called PD-1 on the surface of certain immune cells. These immune cells are called T-cells. Blocking the protein triggers the T-cells to find and kill cancer cells.

You might have pembrolizumab if you:

• have squamous cell laryngeal cancer

• have a cancer that has spread to other parts of the body and has not been treated. Or it has come back (recurrent) and you can’t have surgery

• have a protein called PD-L1 on your cancer cells

You can have pembrolizumab for up to two years, but it might be stopped earlier if your cancer progresses. It is often given on its own. In certain situations, you might have it together with chemotherapy. 

Nivolumab (Opdivo)

Nivolumab is a type of immunotherapy called a checkpoint inhibitor. They block proteins that stop the immune system from attacking the cancer cells. It helps to make your immune system find and kill cancer cells.

Nivolumab is available on the NHS in the UK. You can have nivolumab if you have:

• squamous cell laryngeal cancer that has come back or spread to other parts of the body
• had platinum based chemotherapy (such as cisplatin or carboplatin) and your cancer has started to grow within 6 months of having chemotherapy

In Scotland, the Scottish Medicines Consortium (SMC) says that you can have nivolumab if your cancer continues to grow while on or after having platinum based chemotherapy. You can have it for up to 2 years.

Having targeted and immunotherapy drugs for laryngeal cancer

You have your treatment through a tube into your bloodstream.

A nurse puts a small tube into a vein in your hand or arm and connects the drip to it. Or you might have a central line. This is a long plastic tube that gives the drug into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment.

Side effects

The side effects of targeted and immunotherapy cancer drugs are different depending on the drug you’re having. Not everyone gets all the side effects.

The side effects you have depend on:

• which drug you have

• whether you have it alone, with other drugs or with other treatments

• the amount of drug you have (the dose)

• your general health

A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on. For more information about the side effects of your treatment, go to the individual drug pages.

Research into laryngeal cancer

Researchers are looking at different types of targeted and immunotherapy drugs for laryngeal cancer. Some of these are used to treat other cancers and some are new.

They are looking at these drugs on their own or combined with other treatments.

When you go home

Treatment for laryngeal cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects you have. Your nurse will give you numbers to call if you have any problems at home.