Dr. Bryan Bell, director of the Earle A. Chiles Research Institute, says a new phase of research on the treatment of these cancers "supports a potential revolutionary approach to radiation in the immunotherapy era."
The research institute is using a $3.4 million, five-year grant from the National Institutes of Health's National Cancer Institute to learn why certain treatment pathways have better results than others. The research arm is part of the Providence Cancer Institute.
Bell says initial studies showed significantly better survival rates for certain treatment protocols, and the new research should help institute scientists understand the reason for the improvements. He says while the findings are preliminary, "they suggest the potential for a substantial improvement in outcomes with these investigational approaches."
Bell says in a press release on the study that the improvements in approaches represent "a paradigm shift" in head and neck cancer treatment.
Men at particular risk
The American Association for Cancer Research identifies head and neck cancers as malignancies that arise in the nasal cavity, sinuses, lips, mouth, salivary glands, throat or larynx. The association has found that head and neck cancers are nearly twice as common among men as they are among women. The organization says "alcohol and tobacco use are the two most important risk factors for head and neck cancers," but there are other factors, including genetics and exposure to viruses or manmade pollutants.
National Cancer Institute data estimates nearly 73,000 Americans were diagnosed with cancer of the oral cavity, pharynx or larynx, the major types of head and neck cancer, in 2025. The institute estimates nearly 17,000 people died from these diseases that year.
Treatment advancements
The Providence press release on the new research explains that the most common treatment protocols for head and neck cancers currently involve radical surgery and broad-field radiation with chemotherapy. Patients receiving this treatment can experience side effects such as changes in their speech, swallowing, taste and appearance. The treatments also can suppress the patients' immune system when they need it most, the release says.
Under that traditional approach, there has been no meaningful improvement in overall survival rates for almost four decades, and about half of all patients die within two years of treatment, according to the release.
Providence Cancer Institute has undertaken a series of clinical trials since 2018 on alternative treatment approaches. This includes a combination of preoperative, or neoadjuvant, immunotherapy plus three doses of radiation. Bell says the studies indicate that preoperative treatment with focused radiation modulates the immune system and tumor cells. The researchers believe this modulation may make the patients' immune system and tumor cells more responsive to immunotherapy.
Promising results
Bell says initial studies show better results from the new approaches. The studies indicate that 83% of patients using the new approaches avoided postoperative chemoradiation. Additionally, the new approaches enable less invasive surgical approaches, promote better tumor control and reduce the toxicity of the treatments. The new approaches also spare lymph nodes, which are key to healing.
Additionally, Bell says, with the traditional approaches, the two-year, event-free survival rate for head and neck cancers unrelated to human papillomavirus was about 45%. That rate is nearing 85% for the new treatment protocols.
Bell adds that a key objective of the new approach is not just to make the existing protocols more effective. "We anticipate the potential for fewer long-term side effects, though this will be rigorously evaluated in the clinical trials," he says.
In search of answers
Providence is enabling patients, including those being treated outside the system, to enroll in the multiyear study.
For the trials, clinicians will follow the investigational treatment protocols for patients with head and neck cancers within structured clinical trial parameters. Those clinician researchers will carefully monitor and document patient outcomes, toxicity and biomarkers, Bell says.
He explains that the researchers will systematically compare these patients' results against historical standards to determine whether the new approaches represent a meaningful advance in care. The researchers also will use the data to better understand the differences.
Bell says the institute's work "may fundamentally change how radiation is integrated with immunotherapy for patients with head and neck cancers."