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Laryngeal Cancer: Targeted Therapy

Targeted therapy uses medicines that target specific proteins or cell functions that help cancer grow. Like chemotherapy, these medicines work throughout the body. But they're targeted to kill cancer cells and sometimes work when chemotherapy does not. They also tend to have less severe side effects. There's currently one targeted therapy medicine approved to treat laryngeal cancer: cetuximab.

Cetuximab

This medicine is a type of targeted therapy called a monoclonal antibody. It’s a lab-made version of an immune system protein. Antibodies can be made to bind to very specific targets. This medicine targets a protein called EGFR (epidermal growth factor receptor). High levels of EGFR are found on the surface of some laryngeal cancer cells. It helps them grow and divide. Blocking EGFR helps slow or even stop cancer cell growth.

Sometimes cetuximab is given along with radiation therapy as a first line treatment for early-stage laryngeal cancers. These are cancers that are small and have not spread. It may also be used for advanced laryngeal cancers or those that come back (recur) after treatment. In this case, it is used along with chemotherapy. 

This medicine is given by infusion into a vein. It's usually given either once a week or every other week.

Common side effects can include:

  • Acne-like rash on the face and chest

  • Headache

  • Fever

  • Nausea

  • Feeling tired

  • Diarrhea

While rare, these more serious side effects can occur:

  • A severe allergic reaction involving breathing problems and low blood pressure. This is mostly likely to happen while getting your first dose (you'll be given medicines before each dose to help prevent this).

  • Increased risk of serious heart problems, including fatal heart attacks

  • Increased risk of low magnesium levels

Your blood pressure will be checked often during treatment. Your blood counts will also be checked, and you'll be closely watched for signs of problems. Be sure to tell your healthcare team if you have any symptoms during or after treatment.

Working with your healthcare provider

If you get targeted therapy, talk with your healthcare team about what side effects to look for and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings, holidays, and weekends?

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.

More targeted medicines being tested

If you have laryngeal cancer, your healthcare provider might talk with you about cetuximab. Other types of targeted therapy are also being studied for laryngeal cancer. These new medicines are being tested in clinical trials. Talk with your provider if you’re thinking about being part of a clinical trial. Your provider can help you find a clinical trial that might be right for you.

Medical Reviewers:

  • Jessica Gotwals RN BSN MPH
  • Sabrina Felson MD
  • Todd Gersten MD