A subtype of head and neck cancer, throat cancer is one of the most widely prevalent cancers in the world today. This cancer type remains a global health concern prompting an increased effort in early prevention, detection and new lines of treatment to mitigate its toll and impact. While the traditional lines of treatment namely chemotherapy, radiation therapy and surgery are deemed to be the standard line of treatment for this cancer type, immunotherapy has shown considerable potential in reducing side effects associated with throat cancer. When used in combination with the three modalities, immunotherapy can improve survival rates and improve cancer outcomes and offers new hope in the battle against throat cancer.
What Is Throat Cancer ?
Throat cancer is the type of cancer that generally develops in the throat (pharynx) or the voice box (larynx), but can also be referred to the cancers that start in the esophagus or the thyroid. Throat cancer occurs when the cells in the throat develop genetic mutations. These mutations and genetic alterations allow the cells to grow uncontrollably and proliferate further. These accumulated cells then result in the development of tumors which then interfere with the organ’s normal functions.
There are several risk factors that contribute to the development of throat cancers. Some of these risk factors include –
- Smoking or chewing tobacco.
- Excessive consumption of alcohol.
- Viral infections such as the human papillomavirus (HPV) or the Epstein-Barr virus.
- A diet lacking in fruits and vegetables.
- Any preexisting health condition such as gastroesophageal reflux disease (GERD).
Types Of Throat Cancer
There are several types of throat cancers. They include –
- Nasopharyngeal Cancer – Nasopharyngeal cancer begins in the nasopharynx which is located in the upper part of the throat behind the nose and near the base of the skull. The most common type of cancer that is found in the nasopharynx is the nasopharyngeal carcinoma (NPC). There are different types of NPC and they all begin in the epithelial cells that line up the nasopharynx.
- Oropharyngeal Cancer – Oropharyngeal cancer is a type of throat cancer that develops in the tonsils, back of the throat, tongue or the roof of the mouth. This type of cancer occurs most often in older adults, with 63 years being the average age of diagnosis. Although, it is also important to note that around 20% of cases are seen in people below the age of 55. Apart from the risk factors that are the cause for a majority of throat cancers, Oropharyngeal cancer can also develop due to contracting HPV.
- Hypopharyngeal Cancer – Hypopharyngeal cancer is a rare type of throat cancer that develops in the bottom part of the throat just behind the voice box (larynx). This type of cancer forms in the tissues of the hypopharynx, which is made up of three areas called the piriform sinus, the posterior hypopharyngeal wall and the posterior cricoid region. Cancers that begin in the hypopharynx may spread to other parts of the body such as the thyroid, the trachea or the larynx.
What Is Immunotherapy ?
Emerging as the fourth modality in cancer treatment, immunotherapy is a line of treatment that activates the immune system to identify and recognize and attack cancer cells in the body. Cancer immunotherapy aims to overcome the mechanisms tumors use to evade and suppress the immune responses. This resets the immune system’s protective balance and enhances or restores its capacity to identify and eliminate cancer cells from the body. When used in combination with the conventional lines of treatment, immunotherapy can show positive results for patients diagnosed with throat cancers.
Treatment for throat cancer today is not just focussed on removing the cancer. Doctors and experts have also diverted their efforts towards developing treatments that limit side effects and limit the possibility of a recurrence. Immunotherapy is one such line of treatment that can help to attain these outcomes.
Checkpoint Inhibitors For Throat Cancer
Checkpoint Inhibitors have emerged as a reliable form of treatment over the past decade. These drugs block the checkpoint proteins and give permission to the healthy cells of the body to continue fighting cancer. One of the key functions of the immune system is to differentiate between the healthy cells of the body and any foreign agents that may have entered the body. The immune responses of the body then get rid of any foreign substances while sparing the healthy cells alone.
In order to separate between the healthy cells and the harmful cells of the body, the immune system uses checkpoint proteins that are found on the surface of the cells. These checkpoints can be understood as something similar to a switch that needs to be turned ‘on’ or ‘off’ to trigger an immune response. However, the immune system fails to take notice of these checkpoints when it comes to cancerous cells. This is due to the fact that cancer cells are healthy cells of the body that have attained mutation. This makes it difficult for the immune system to recognize these cells as foreign entities. The cancer cells in the body use these checkpoints to evade the immune responses and thereby proliferate in the body.
PD-1 Inhibitors Drugs
Pembrolizumab and Nivolumab are two drugs that target the PD-1 protein. By blocking this protein, checkpoint inhibitors allow the immune responses of the body to take care of the cancer cells in the body. For patients with laryngeal or hypopharyngeal cancer that has recurred after treatment or that has metastasized to other parts of the body, pembrolizumab may be used either alone or in combination with chemotherapy. Nivolumab and Pembrolizumab can also be administered to the patient alone if chemotherapy doesn’t offer any benefits. These drugs are typically given as IV infusions typically over a period of 3,4 or 6 weeks.
Side Effects Of Checkpoint Inhibitors
Some of the most common side effects of checkpoint inhibitors include –
- Fatigue
- Cough
- Nausea
- Diarrhea
- Skin Rash
- Constipation
- Joint Pain
While these side effects are usually mild, there may also occur some serious side effects. These include –
- Infusion Reactions – Some patients may experience infusion reactions because of checkpoint inhibitors. These may be similar to an allergic reaction and may result in fever, chills, flushing of the face, wheezing and having difficulty breathing.
- Autoimmune Reactions – Sometimes these drugs may result in the immune responses working in overdrive and may start affecting the healthy cells of the body. This can cause some serious or even life threatening situations for a patient and it is imperative that patients consult their doctors about these symptoms as soon as possible.
DENVAX: Dendritic Cell Therapy For Cancer
DENVAX, a groundbreaking therapy in the realm of cancer treatment, focuses on harnessing the potential of dendritic cells. DENVAX can seamlessly integrate into existing treatment plans without causing significant disruptions to daily life of a patient.
While cancer cells may evade the immune system and its responses, DENVAX boosts these responses by deploying activated dendritic cells. These specialized immune cells then trigger strong immune responses that traverse the body, effectively targeting and eliminating the malignant cells. A form of adjuvant therapy, DENVAX harmoniously complements surgery, radiation, and chemotherapy, contributing to a comprehensive, multi-disciplinary approach.
Noteworthy benefits of DENVAX include its role in enhancing the quality of life, extending lifespan, and improving clinical outcomes for patients with throat cancer. Its user-friendly nature and compatibility with other modalities make it an ideal choice for personalized cancer care. In cases of advanced stage IV cancer, DENVAX serves as palliative therapy, providing comfort to patients while maintaining safety and minimal toxicity.
Final Note
Developing diverse treatments is integral to improve outcomes against cancer. Immunotherapy when used in combination with traditional modalities of cancer can significantly improve outcomes for throat cancer.
