Locally advanced laryngeal (LAR) and hypopharyngeal (HYPO) squamous cell carcinoma may be treated with induction chemotherapy (IC) followed by radiotherapy (RT) for larynx preservation (LP) as an alternative to total laryngectomy (TL). However, not all patients benefit from LP strategy and up to 30-40% end up having a TL. The current proposal will personalise patients’ management to increase the rate of LP, by maximising the probability of response to induction treatment.
Preserve will collect and integrate a large series of clinically annotated data from LAR/HYPO cancer patients treated with IC followed by RT, to assess a multi-omic signature of response to IC and to define alternative pathways. Transcriptomic analysis, molecular data on cell lines and radiomic evaluation will be main components of this signature.
Our predictive models integrated into an intuitive clinical decision support system will be validated in a phase II feasibility trial with tailored systemic induction treatments, according to the discovered signature, providing evidence for clinical translation.
A cost-utility analysis of our personalised treatment in LAR/HYPO cancer integrating quality of life measures will assess sustainability of personalised medicine in clinical setting.
