Where laryngeal cancer treatment is heading
Laryngeal cancer · Updated Nov 14, 2026
About 12,000 people in the US are diagnosed with cancer of the larynx (voice box) each year, most linked to smoking and alcohol. Early cancers are often cured with radiation or small surgery that keeps the voice. For advanced cancers, cisplatin-based chemoradiation can save the larynx in many people; others need laryngectomy. Immunotherapy is now being added around surgery, and new trials aim to save more voice boxes with less toxic treatment.
- 110studies open or running
- 14phase 3 trials
- 507papers published this year
- 10NIH-funded projects
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Now
Nov 2026
Immunotherapy around surgeryHappened 57.6% event-free at 3 years
Pembrolizumab before and after surgery: 57.6% event-free at 3 years vs 46.4%. FDA approved June 2025.
57.6%: event-free at 3 years, vs 46.4% with standard care.
Immunotherapy after surgery for high riskHappened 63.1% disease-free at 3 years
Adding nivolumab to postoperative chemoradiation: 63.1% disease-free at 3 years vs 52.5%.
63.1%: disease-free at 3 years, vs 52.5% without nivolumab.
Dropping cisplatin is not yet safeHappened 65.1% laryngectomy-free at 2 yrs
A cisplatin-free pembrolizumab approach kept 65.1% alive without laryngectomy, not better than the 59% benchmark.
65.1%: alive without laryngectomy at 2 years, vs 59% historically.
-
6 months
by May 2027
Which cisplatin schedule is betterLikely
NRG-HN009 (475 people) compares weekly with every-3-weeks cisplatin during radiation; due February 2027.
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12 months
by Nov 2027
Immunotherapy to save the larynxPossible
Germany's ELOS trial (140 people) adds pembrolizumab to larynx-preservation treatment; due December 2028.
Neoadjuvant immunochemotherapy before smaller surgeryPossible 100% kept laryngeal function
Early results kept laryngeal function in all 39 eligible patients; randomized trials are needed.
100%: kept laryngeal function after reduced surgery.
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3 years
by late 2029
Pembrolizumab before surgery, with or without chemoPossible 57.6% event-free (KEYNOTE-689)
A National Cancer Institute trial (188 people) tests pre-surgery immunotherapy; due June 2029.
57.6%: event-free at 3 years, vs 46.4% with standard care.
Less neck radiationPossible
PRIMO (242 people) uses sentinel-node biopsy to decide which parts of the neck need radiation; due December 2029.
-
5 years
by late 2031
Options for people who cannot have cisplatinLong shot
NRG compares radiation plus cetuximab with radiation plus other chemotherapy (454 people); due 2035.
Less radiation after surgeryLong shot
DIREKHT2 (508 people) tests safely reducing postoperative radiation; due December 2031.
The research paths
Immunotherapy in curative treatment
57.6% event-free at 3 yearsDetails and 2 trialsHide
PD-1 drugs before and after surgery or with chemoradiation.
WatchNCI pre-surgery trial; NIVOPOSTOP survival data.
Saving the voice box
65.1% laryngectomy-free at 2 yrsDetails and 1 trialsHide
Testing immunotherapy and response-adapted surgery to preserve the larynx.
WatchELOS; REMATCH follow-up.
Less toxic radiation and chemotherapy
Details and 5 trialsHide
Better cisplatin schedules, smaller radiation fields and alternatives to cisplatin.
WatchNRG-HN009; PRIMO.
- Weekly vs every-3-weeks cisplatin with radiation (NRG-HN009)NRG Oncology · 475 people · fully enrolled Feb 2027
- Sentinel-node-guided neck radiation (PRIMO)Radboud University · 242 people · enrolling Dec 2029
- Less radiation after surgery (DIREKHT2)University of Erlangen · 508 people · enrolling Dec 2031
- Radiation plus cetuximab vs radiation plus chemotherapyNRG Oncology · 454 people · enrolling Nov 2035
- Adding cetuximab to standard treatmentNational Cancer Institute · 158 people · enrolling Dec 2032
Borrowed from other cancers
From Melanoma and lung cancer
Pembrolizumab
Approved
A PD-1 immunotherapy now approved around surgery for head and neck cancer.
From Melanoma and lung cancer
Nivolumab
Phase 3
A PD-1 immunotherapy tested after surgery for high-risk disease.
Open to join now
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Head and neck squamous cancer
Adding cetuximab
Locations and eligibility → -
Advanced head and neck cancer
Radiation plus cetuximab vs chemotherapy
Locations and eligibility → -
Larynx and hypopharynx cancer
Sentinel-node-guided neck radiation
Locations and eligibility → -
Locally advanced laryngeal cancer
Pembrolizumab for larynx preservation
Locations and eligibility → -
Locally advanced head and neck cancer
Pembrolizumab before surgery
Locations and eligibility →
See every recruiting Laryngeal cancer trial →
When the trials finish
Completion dates the trials registered. Results usually follow 3 to 12 months later.
- Heating up
- Maturing
- Early
- Cooling
- Fully enrolled, waiting on results
- Still enrolling
What just happened
Cisplatin-free larynx preservation misses goal
SMART-KEY, ESMO 2026.
Immunochemotherapy before surgery preserves the larynx
REMATCH, Clinical Cancer Research.
FDA approves perioperative pembrolizumab
KEYNOTE-689, NEJM.
Standard treatment today
- Early (stage I-II)Radiation or laser/transoral surgery, preserving the voice in most people.
- Locally advanced, larynx preservationRadiation with cisplatin, or induction chemotherapy then radiation.
- Locally advanced, surgeryLaryngectomy, then radiation with or without cisplatin; pembrolizumab before and after for PD-L1-positive tumors.
- Recurrent or metastaticPembrolizumab alone or with chemotherapy; cetuximab-based options.
How to read this page, and sourcesHow to read this page, and sources
- Most immunotherapy trials include several head and neck cancer sites (mouth, throat, larynx); laryngeal cancer is one part of each.
- Forecasts are editorial judgments by Find a Trial, not predictions from sponsors or regulators.
See Laryngeal cancer trials recruiting now →