ORIGINAL RESEARCH article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1626880
This article is part of the Research TopicAdvancements in Personalized Medicine for Head and Neck Cancer: Molecular-based Approaches to Treatment and CareView all 13 articles
Immunotherapy monotherapy for patients with recurrent nonmetastatic larynx cancer who refuse salvage total laryngectomy
Provisionally accepted- 1West Cancer Center, Memphis, United States
- 2Emory University, Atlanta, United States
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Objectives/Hypothesis: Total laryngectomy has traditionally been recommended for patients with recurrent larynx cancer after radiation or chemoradiation. Some patients refuse salvage surgery. Historically, these patients have been placed on hospice or palliative chemotherapy. Immunotherapy has recently added another treatment modality to our armamentarium. Methods: 8 patients with recurrent larynx cancer declined salvage laryngectomy. They were started on immunotherapy alone. We recorded their demographics, initial cancer stage, initial cancer treatment, combined positive score (CPS) values, need for tracheostomy, addition of chemotherapy to their immunotherapy, and response to therapy. Results: 62.5% were African American, while 37.5% were Caucasian. Most had early (stage 1 or 2 disease) at the time of initial diagnosis. 75% had radiation alone as their initial treatment, while 25% had chemoradiation. All of these patients had high CPS scores. 37.5 % progressed on 4 rounds of immunotherapy and are deceased. Chemotherapy was added to the regimen of 50% of the patients after poor response to immunotherapy. 75% of these patients are all still alive after 1 year of treatment. 75% of all patients needed tracheostomy while on salvage treatment. One patient (12.5%) has had a long-lasting positive response to immunotherapy alone. Conclusions: Our patients with nonmetastatic recurrent larynx cancer were found to have high CPS scores, which suggests favorable response to immunotherapy. Most patients with recurrent larynx cancer on immunotherapy required a tracheostomy. These patients had poor response on immunotherapy alone, but had prolonged survival with added chemotherapy. Salvage laryngectomy is the only curative option for these patients, but for those patients that refuse surgery, chemotherapy with immunotherapy has better results than immunotherapy alone. Our results reveal a possible clinical phenomenon, which needs to be confirmed by large sample studies.
Keywords: Larynx cancer, head and neck cancer, Squamous cell carcinoma, Cervical metastasis, Recurrence, Immunotherapy, prognosis, Laryngectomy
Received: 12 May 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Shires and Sebelik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Courtney Brooke Shires, cshires1@gmail.com
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