Research into mouth and oropharyngeal cancer

Researchers around the world are looking at better ways to prevent, diagnose and treat mouth and oropharyngeal cancer.

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for mouth and oropharyngeal cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follows the patients for a period of time and collects and analyses the results. We have included this ongoing research to give examples of the type of research being carried out in mouth and oropharyngeal cancer.

Research and clinical trials

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they work
• they work better than the treatments already available
• they are safe

Research into the risks and causes of mouth and oropharyngeal cancer

Gene changes

Scientists are looking into changes in genes that may make a cancer develop in the head and neck area. They are interested to know:

• which gene changes are important
• how the gene changes affect the immune system
• whether this can help develop better treatments in the future

Diet

Researchers have looked at diet and the risk of head and neck cancers. The results suggest that a diet containing non starchy vegetables may protect you against mouth and oropharyngeal cancer. Non starchy vegetables include brussel sprouts, broccoli and cabbage. 

A diet high in fresh fruit might also reduce your risk of mouth cancer. We need further research about the role diet plays.

Research into treatments for mouth and oropharyngeal cancer

You might have a combination of treatment types for mouth and oropharyngeal cancer. Researchers are looking at different combinations of treatment. And the best order to give them.

We know that oropharyngeal cancers containing the human papilloma virus (HPV) tend to do better than cancers that don’t contain HPV. Researchers want to find out whether people with HPV cancers could have less intensive treatment. As a result, they might have fewer side effects.

Surgery 

Surgeons use a type of surgery called transoral robotic surgery (TORS). This aims to remove the cancer and a border of normal tissue around it (a margin). Some people have treatment such as radiotherapy after their surgery. This is called adjuvant treatment and aims to lower the risk of the cancer coming back. 

A research study is looking at people who had TORS for oropharyngeal cancer in the past. And who has not had adjuvant treatment. They are looking at:

• whether or not the cancer came back (recurrence)
• how the margins affected recurrence

The researchers want to find out more about who needs to have adjuvant treatment. They think that surgery alone might be enough treatment for some people with oropharyngeal cancer.

Radiotherapy

Doctors are looking for better ways of giving radiotherapy to treat cancers of the mouth and oropharynx. And how they can reduce the treatment side effects.

Researchers are looking at how they plan radiotherapy. Research studies include:

• using MRI scans as well as CT scans to plan radiotherapy
• planning your radiotherapy again during your treatment. The aim is to reduce the radiotherapy to the surrounding organs by targeting the cancer better

They are also looking at different ways to give radiotherapy. Research studies include:

• comparing intensity modulated radiotherapy (IMRT) with proton beam radiotherapy
• comparing different doses of radiotherapy
• combining radiotherapy or chemoradiotherapy with a targeted or immunotherapy drug
• giving a radio sensitising drug alongside radiotherapy. These increase oxygen levels in cancer cells so that radiotherapy can kill more of them

Radiotherapy can cause side effects. Some of these may last for months or longer after treatment. Some research studies are looking at ways to reduce these side effects. These include: 

• developing a computer tool to predict your risk of getting long term side effects after radiotherapy
• looking at how different ways of giving radiotherapy to your neck affect swallowing after treatment

Targeted cancer drugs and immunotherapy

Targeted cancer drugs work by ‘targeting’ those differences that help a cancer cell to grow and survive. Some seek out and destroy cancer cells. Others help the body's immune system to attack the cancer. So some of these drugs are also called immunotherapies.

Researchers are comparing targeted drugs with chemotherapy for mouth cancer that has spread or come back. They are also looking at the best time to give these treatments and ways to reduce the side effects.

Trials are looking at the following drugs:

• pembrolizumab on its own or with other drugs
• nivolumab
• lenvatinib
• atezolizumab

Doctors are also looking at different ways of giving new immunotherapy drugs. One trial is looking at injecting an immunotherapy drug directly into the cancer.

Vaccine therapy

Doctors are looking at a vaccine called RNA for people with cancers of the head and neck. The aim is to help the immune system recognize and attack a type of virus called HPV16. This is a type of human papilloma virus (HPV) that can cause cell changes that can develop into cancer.

Research into living with mouth and oropharyngeal cancer

Researchers are looking at ways to relieve the side effects of treatment. And find out how they can best support people with mouth and oropharyngeal cancer. 

Mouth Problems 

It’s common for people with mouth and oropharyngeal cancer to have mouth problems caused by their cancer or the treatment. Researchers are looking at ways of preventing or improving symptoms such as:

• dry mouth (xerostomia)
• painful mouth (mucositis)
• difficulty opening your mouth (trismus)

Preventing damage to the jaw bone 

Rarely, radiotherapy to the head and neck can damage the jaw bone. This damage is called osteoradionecrosis. Doctors have been looking at ways of preventing this damage including:

• high pressure oxygen (hyperbaric oxygen HBO)
• drugs such as pentoxifylline and vitamin E

Difficulty swallowing 

A common side effect of treatment is having difficulty swallowing. This can happen with radiotherapy or surgery. Doctors are comparing a type of surgery called transoral surgery with a type of radiotherapy called intensity-modulated radiation therapy (IMRT). They want to find out which one causes the least problems with swallowing.

Support

Doctors want to find out how they can improve support for people with head and neck cancers. To do this, researchers are asking patients to fill in a questionnaire to identify things that concern them.

You then discuss your concerns with a doctor who can provide guidance and information. Doctors hope it will help them support patients and improve care in the future.