Biological therapy for cancer of the larynx

This page is about biological therapies for cancer of the voice box (larynx) and there is information about

A quick guide to what's on this page
What biological therapy is
Cetuximab (Erbitux)
Other biological therapies
Side effects of biological therapies
Getting more information

What biological therapy is

Biological therapy is treatment that changes the activity of substances made naturally in the body. These therapies can control or destroy cancer cells. The most common biological therapy used for cancer of the voicebox (laryngeal cancer) is cetuximab.

Biological therapies used for laryngeal cancer

Cetuximab (Erbitux) blocks areas on the surface of cancer cells that can trigger growth. Cetuximab combined with radiotherapy is used for people with locally advanced laryngeal cancer if chemotherapy is not working or can't be used.

Newer biological therapies are being used in clinical trials for laryngeal cancer. The therapies include gefitinib (Iressa), zalutumumab and everolimus.

Possible side effects

The side effects will depend on which biological therapy you have but may include tiredness, diarrhoea, skin changes, a sore mouth, weakness, loss of appetite, low blood counts, and fluid build up in parts of the body.

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Biological therapy is treatment that changes the activity of substances made naturally in the body. These therapies can control or destroy cancer cells.

Cetuximab (Erbitux) is a type of biological therapy known as a monoclonal antibody. It is designed to block areas on the surface of cancer cells that can trigger growth. These are called epidermal growth factor receptors (EGFR). Blocking these receptors can stop the signals that tell the cancer to grow. Trials have shown that cetuximab combined with radiotherapy can help people with locally advanced head and neck cancer to live longer than radiotherapy alone.

The National Institute for Health and Clinical Excellence (NICE) and the Scottish Medicines Consortium (SMC) have given guidance about cetuximab. They have approved its use with radiotherapy, for locally advanced squamous cell head and neck cancer, if platinum based chemotherapy (such as cisplatin or carboplatin) is not working, or cannot be used. Locally advanced cancer means cancer that has spread into the areas close to the voicebox, but not to other areas of the body such as the bone or distant lymph nodes.

Cetuximab is now also licensed in Europe in combination with platinum based chemotherapy, for people with squamous cell head and neck cancer that has come back or has spread. This decision was based on the results of a large international trial called EXTREME, which compared cetuximab and chemotherapy to chemotherapy alone. Patients on this trial hadn't been treated before with chemotherapy. The results suggested that adding cetuximab to chemotherapy helped people to live between 2 and 3 months longer than if they just had chemotherapy on its own.

But in 2009 the SMC in Scotland and NICE in England decided not to recommend cetuximab for this group of patients on the NHS because, in their opinion, it is not cost effective.

Newer biological therapies are being used in trials for head and neck cancer, including cancer of the voicebox. The therapies include gefitinib (Iressa), zalutumumab and everolimus (Afinitor). You can find information about these on the laryngeal cancer research page.

The side effects will depend on which biological therapy you have but may include

Tiredness (fatigue)
Diarrhoea
Skin changes (rashes or discolouration) – rashes may be severe for some people
A sore mouth
Weakness
Loss of appetite
Low blood counts
Swelling of parts of the body, due to fluid build up

Tell your doctor if you have any of these effects as you can have medicines to help to control them. There is information about the side effects of individual biological therapies in our biological therapy section.

Look at the main biological therapy section in CancerHelp UK for more detailed information. You can ask your doctor or specialist nurse to write down the names of the drugs you will have so you can look them up in our specific drug side effects section. There are pages there for all the most commonly used biological therapy drugs. Each page has information about common, occasional and rare side effects for that drug.

Our laryngeal cancer organisations page gives details of people who can give information about biological therapies. Some organisations can put you in touch with a cancer support group. Our laryngeal cancer reading list has information about books and leaflets on cancer treatments.