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Ablative Radiotherapy to Restrain Every Metastasis Safely Treatable (ARREST-2): A Randomized Phase II/III Trial
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What is head and neck cancer?
Head and neck cancer is a group of cancers that start in the moist linings of the mouth, nose, sinuses, throat, voice box, and salivary glands; brain tumors, eye cancers, and thyroid cancer are counted separately. About 9 in 10 are squamous cell carcinomas. The main sites are the oral cavity (lips, tongue, gums, floor of the mouth), the oropharynx (tonsils, base of the tongue, soft palate, the part people mean by "throat cancer"), the larynx or voice box, and the hypopharynx and nasopharynx. Symptoms depend on site: a mouth sore that does not heal, a lump in the neck, persistent sore throat or ear pain, trouble swallowing, hoarseness lasting more than a few weeks, or a white or red patch in the mouth. Dentists often spot oral cancers first. The disease is more than twice as common in men, and the average age at diagnosis is 64, though HPV related cases tend to be younger.
Two different diseases now live under one name. Tobacco and alcohol related cancers, which have declined as smoking fell, tend to occur in the mouth and larynx and respond less well to treatment. HPV related cancers of the oropharynx, which have surged, respond better and have higher cure rates, which is why trials are testing whether these patients can safely receive less radiation or chemotherapy. Treatment is surgery, radiation, and chemotherapy in various combinations, with cisplatin and radiation the standard for many locally advanced cancers, and immunotherapy for recurrent or metastatic disease since 2016. In 2025 the FDA approved pembrolizumab given before and after surgery for resectable locally advanced disease, the first immunotherapy approval in the curative setting. Because treatment affects speaking, swallowing, and appearance, trials measure quality of life as closely as survival. The HPV vaccine prevents the infections that cause these cancers; see our HPV page.
Head and neck cancer immunotherapy: where it stands
Checkpoint inhibitors, which release the immune system's brakes, became standard for recurrent and metastatic head and neck cancer in 2016 and are now moving earlier. The 2025 approval of pembrolizumab around surgery followed a Phase 3 trial showing fewer recurrences, and a 200 site National Cancer Institute trial is testing whether adding cetuximab, an antibody against a growth signal, improves on immunotherapy in metastatic disease. Other studies combine immunotherapy with chemotherapy before surgery to shrink tumors, with photodynamic therapy, or with new bispecific antibodies. The open question for many patients is not whether immunotherapy helps but which patients, at which stage, and in what combination, which is exactly what current trials sort out.
Types of head and neck cancer clinical trials
Immunotherapy trials. Checkpoint inhibitors before and after surgery, in combination with chemotherapy or antibodies, and in metastatic disease.
De-escalation trials for HPV related cancer. Testing whether less radiation or chemotherapy cures HPV positive throat cancer with fewer long term side effects.
Radiation technology trials. Proton therapy, ultra high dose rate FLASH radiation, and techniques to spare the salivary glands and swallowing muscles.
Trials for older adults. Treatment regimens designed for people 65 and older, who are often excluded from standard trials.
Targeted and novel therapy trials. Antibodies against EGFR and MET, photodynamic therapy, and new drugs for cancers that have stopped responding.
Supportive care and access studies. Swallowing rehabilitation, mouth sore prevention, and programs that bring specialist care to rural patients.
Who can participate in head and neck cancer clinical trials?
Trials specify site, stage, HPV status, and treatment history. Trials around surgery enroll people with newly diagnosed, resectable, locally advanced cancer before treatment begins. Chemoradiation trials enroll locally advanced disease, often split by HPV status. Recurrent and metastatic trials require progression after specific prior treatments and often PD-L1 testing. Trials for older adults enroll people 65 and older who might not tolerate standard regimens. Most require adequate organ function, the ability to manage daily activities, and, for radiation trials, dental evaluation first. Supportive care and access studies have wider doors. Eligibility always varies by study; our guide covers eligibility criteria.
What is the newest treatment for head and neck cancer?
Pembrolizumab given before and after surgery for resectable locally advanced cancer, approved in 2025, the first immunotherapy approval aimed at cure. In trials, de-escalated treatment for HPV positive cancer, FLASH radiation, and new antibody combinations are being tested.
The stages of head and neck cancer, and why they matter for trials
Stage I and II. Small tumors with no lymph node spread. Surgery or radiation alone, with high cure rates; trials focus on function sparing techniques.
Stage III and IVA/B (locally advanced). Larger tumors or spread to neck lymph nodes. Combined surgery, radiation, and chemotherapy, now with immunotherapy for some; the largest group of trials. HPV positive oropharyngeal cancer is staged separately because it behaves better.
Stage IVC (metastatic) and recurrent. Spread to distant organs or return after treatment. Immunotherapy and new drug trials recruit here.
Study titles name the site, say "resectable," "locally advanced," or "recurrent/metastatic," and often "HPV positive" or "HPV negative." Your pathology report, including HPV (p16) status, tells you which studies fit.
How to enroll in a head and neck cancer clinical trial
Identify your trial. Use the filters and search your site by name, "oropharyngeal," "oral cavity," or "laryngeal," as well as "head and neck." Titles state the stage and HPV status required.
Select your preferred location. Enter your city or state. Large Phase 3 trials run at many sites; proton and FLASH radiation trials at a few centers.
Explore study details. Click "Learn More" for HPV and PD-L1 requirements, prior treatments allowed, and the schedule, which for radiation trials is daily for weeks.
Complete the health profile. Click "Get started" to begin the 5-step application. Have three things ready: the site and stage of your cancer, your HPV (p16) and any PD-L1 results, and the treatments you have had.
Submit the application. A clinical trial coordinator reviews it and contacts you. Nothing is decided until informed consent, and participation is voluntary at every step.