From VA Larynx to the future of chemoselection: Defining the role of induction chemotherapy in larynx cancer

Oral Oncol. 2018 Nov:86:200-205. doi: 10.1016/j.oraloncology.2018.09.026. Epub 2018 Oct 1.


Organ preservation protocols utilizing induction chemotherapy as a selection agent have played a critical role in the treatment of advanced laryngeal squamous cell carcinoma (LSCC). The selection of patients who will have a good response to chemoradiation allows for organ preservation in a significant group of patients and minimizes the rate of surgical salvage. While there remains debate regarding its utility when compared to surgery or other organ preservation regimens, the data does suggest an important role for induction chemotherapy in LSCC. In addition, there are continued opportunities to identify pretreatment biomarkers for induction chemotherapy, whether genetic, epigenetic or cellular, that could predict response to treatment and select patients to therapy (whether organ preservation or surgery). As our understanding of the biology of larynx cancer advances, induction paradigms have utility for the development and adoption of novel agents and therapeutics. The background of induction chemotherapy as a selection agent and future directions of this approach are discussed.

Keywords: Advanced laryngeal squamous cell carcinoma; Chemoselection; Induction selection; Organ preservation therapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant / methods
  • Chemotherapy, Adjuvant / trends
  • Clinical Trials, Phase III as Topic
  • Disease-Free Survival
  • Fluorouracil
  • Humans
  • Induction Chemotherapy / methods*
  • Induction Chemotherapy / trends
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy*
  • Laryngectomy / methods
  • Laryngectomy / trends
  • Larynx / pathology
  • Larynx / surgery
  • Neoplasm Staging
  • Organ Sparing Treatments / methods
  • Organ Sparing Treatments / trends
  • Patient Selection*
  • Randomized Controlled Trials as Topic
  • Squamous Cell Carcinoma of Head and Neck / mortality
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / therapy*
  • United States
  • United States Department of Veterans Affairs


  • Fluorouracil