AUTHOR=Mattavelli Davide , Wichmann Gunnar , Smussi Davide , Paderno Alberto , Plana Maria Serrahima , Mesia Ricard Nin , Compagnoni Micaela , Medda Alessandro , Chiocca Susanna , Calza Stefano , Zhan Yinxiu , Rognoni Carla , Tarricone Rosanna , Stucchi Erika , Lorini Luigi , Gurizzan Cristina , Khelik Ksenia , Hovig Eivind , Dietz Andreas , Piazza Cesare , Bossi Paolo TITLE=Is precision medicine the solution to improve organ preservation in laryngeal/hypopharyngeal cancer? A position paper by the Preserve Research Group JOURNAL=Frontiers in Oncology VOLUME=14 YEAR=2024 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1433333 DOI=10.3389/fonc.2024.1433333 ISSN=2234-943X ABSTRACT=

In locally advanced (LA) laryngeal/hypopharyngeal squamous cell carcinoma (LHSCC), larynx preservation (LP) strategies aim at the cure of the disease while preserving a functional larynx, thus avoiding total laryngectomy and the associated impact on the quality of life. In the last decades, apart from transoral and open-neck organ preservation approaches, several non-surgical regimens have been investigated: radiotherapy alone, alternate, concurrent or sequential chemoradiation, and bioradiotherapy. Despite major progress, the identification of reliable and effective predictors for treatment response remains a clinical challenge. This review examines the current state of LP in LA-LHSCC and the need for predictive factors, highlighting the importance of the PRESERVE trial in addressing this gap. The PRESERVE trial represents a pivotal initiative aimed at finding the optimal therapy for laryngeal preservation specific to each patient through a retrospective analysis of data from previous LP trials and prospectively validating findings. The goal of the PRESERVE trial is to develop a comprehensive predictive classifier that integrates clinical, molecular, and multi-omics data, thereby enhancing the precision and efficacy of patient selection for LP protocols.