Researchers around the world are looking at better ways to treat nasopharyngeal cancer and manage treatment side effects.
Go to Cancer Research UK’s clinical trials database if you are looking for a trial for nasopharyngeal 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.
Research and clinical trials
All cancer treatments have to 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 known to be safe
Treatments are developed and tested in laboratories. For safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.
Doctors are looking at how they give radiotherapy to people with nasopharyngeal cancers. You usually have radiotherapy once a day, Monday to Friday, for several weeks. They are comparing different ways of giving radiotherapy to see which way is better at stopping cancer from coming back.
Intensity modulated radiotherapy (IMRT) is a specialised type of radiotherapy. Difficulty swallowing is a side effect of radiotherapy to the head and neck. Researchers have looked at a modified type of IMRT called dysphagia optimised IMRT or Do-IMRT. This is to reduce the radiation dose to the muscles that control swallowing. Doctors want to see if this improves swallowing after treatment.
Targeted cancer drugs
Targeted cancer drugs change the way cells work. They can boost the body's immune system to fight off or kill cancer cells, or they can block signals that tell cells to grow.
Doctors have looked at different types of targeted cancer drugs for nasopharyngeal cancer including:
- monoclonal antibodies such as cetuximab and zalutumumab
- cancer growth blockers, such as buparlisib and Iressa
Doctors are waiting for results from a trial to see if adding buparlisib to chemotherapy improves how well the treatment works. Another trial was looking at how zalutumumab works in the body for people with head and neck cancer.
Immunotherapy works by helping the immune system recognise and attack cancer cells. There are different types being looked at in head and neck cancer.
Scientists have been developing a vaccine containing the Epstein Barr virus (EBV). EBV is thought to be linked to some nasopharyngeal cancers. Researchers hope a vaccine that gets the body’s immune system to recognise and attack EBV might kill cancer cells containing the virus. Results from an early phase trial showed that the vaccine was safe to use, with only mild side effects.
T4 immunotherapy is a new cancer treatment. It works by helping a type of white blood cell called T cells attack the cancer. Early research is testing the safest dose of T4 immunotherapy in people with head and neck cancers. Doctors also want to find out if the treatment shrinks or controls the cancer.
Using viruses to treat cancer
Doctors have been looking at a drug called Reolysin as a treatment for head and neck cancers that have come back or spread. Reolysin is a cancer treatment made from a type of virus called reovirus.
Reovirus is a common virus and rarely causes illness, but it can kill cancer cells. Researchers want to find out whether Reolysin with chemotherapy helps people with head and neck cancer.
Tests during and after treatment
Doctors are keen to find a more accurate way of seeing whether there are any cancer cells left after treatment. They hope that using a type of MRI scan called diffusion weighted MRI (DW-MRI) might be useful. DW-MRI scans measure the water movement between cells.
Researchers want to find out whether DW-MRI scans are helpful for seeing how well treatment for head and neck cancer has worked. Doctors hope the scans will help them decide who needs more treatment.
Side effects of treatment
Treatment for nasopharyngeal cancer causes side effects that can be difficult to live with. Researchers are looking into different drugs and treatments to help with these treatment side effects.
Preventing or treating bone damage
Rarely, radiotherapy to the head and neck area can damage the jaw bone. This is called osteoradionecrosis (ORN). Doctors think that a high pressure oxygen therapy called hyperbaric oxygen (HBO) may be able to prevent or treat this side effect. The idea is that HBO works by increasing the supply of blood to the jaw.
Researchers are looking at HBO therapy to prevent jaw bone problems in people having dental or jaw surgery after radiotherapy. They are also looking at whether HBO can help the jaw bone heal after surgery to remove a damaged jaw bone.
Some medications such as vitamin E and pentoxyphylline are thought to help prevent and help treat ORN. Some researchers are testing to see whether they help.
Helping to relieve a dry mouth
One of the main side effects of radiotherapy to the head and neck area is a dry mouth. Doctors call this xerostomia (pronounced zero-stow-mee-a). Radiotherapy affects the glands that make saliva (spit) to keep your mouth moist. You may make less saliva than usual or none at all.
Having a dry mouth can make chewing, swallowing and talking difficult. So doctors are looking into new ways to prevent a dry mouth.
- medical devices to stimulate the gums to increase the amount of saliva
Helping to relieve a sore mouth
Radiotherapy for head and neck cancers can cause painful sores and ulcers in the mouth. This is called oral mucositis.
Doctors are looking at a new treatment for oral mucositis called low level laser therapy. They shine a weak laser light on the lining of the mouth to see if it:
- reduces pain during and after radiotherapy
- helps heal the mouth after treatment.
A number of drugs are also being developed to reduce oral mucositis with radiotherapy, or reduce the discomfort of oral mucositis.
Help opening your mouth
Some people also find it difficult to open their mouth after radiotherapy. This is called trismus. It happens because radiotherapy can affect the muscles that you use to open and close the mouth.
Some researchers are looking at using a device that helps to gently stretch the jaw muscles. The team are interested in treating the trismus and helping people have a better quality of life.