Laryngeal Cancer: Drug Therapy

Therapeutic targets

• Cure or slowing of tumor growth.
• Palliative (palliative treatment)

Therapy recommendations

• First-line methods are surgery and radiotherapy. The latter is often performed as radiochemotherapy (RCTX).
• Primary radiochemotherapy, followed by salvage surgery if necessary.
  • Cytostatic therapy: induction chemotherapy ( form of chemotherapy initially aimed at acute reduction of tumor volume or tumor cell count) + surgery/radiotherapy/radiochemotherapy.
    • Chemotherapy is used in the treatment of subglottic carcinoma, often in combination with radiotherapy for inoperable tumors and/or distant metastases
    • Combinations of the following agents: cisplatin + docetaxel; carboplatin + 5-FU (5-fluorouracil).
• If necessary, use EGFR-1 inhibitor cetuximab (combined with radiotherapy/radiochemotherapy).
• In advanced stages, palliative therapy (palliative treatment) is given:
  • Patients with recurrence (recurrence of the disease) or metastasis (formation of daughter tumors) after exhaustion of locoregional curative therapy options (surgery or radiotherapy) receive palliative systemic therapy:
    • In good general condition (= ECOG 0 to 1): platinum (preferably cisplatin) and 5-FU in combination with cetuximab in first-line therapy.
    • PD-1 inhibitors as second-line therapy.
  • Enteral nutrition, e.g., feeding via a PEG (percutaneous endoscopic gastrostomy: endoscopically placed artificial access from the outside through the abdominal wall into the stomach)
  • Infusion therapy via a port catheter (port; permanent access to venous or arterial blood circulation).
  • Pain therapy (according to WHO staging scheme; see “Chronic pain” below).
• See also under “Further therapy”.

No detailed information on active ingredients and dosages is provided here, as therapy regimens are constantly being modified.