Induction Chemotherapy Followed by Chemoradiotherapy for Head and Neck Cancer

Inclusion Criteria:

• Pathologically proven diagnosis of HPV-positive squamous cell carcinoma of the oropharynx, hypopharynx, or larynx. HPV-positivity will be defined as tumors that are p16-positive by immunohistochemistry.
• Clinical stage III or IV disease; Note: Patients with M1 tumors are not eligible.
• Appropriate stage for protocol entry, including no distant metastases, based upon minimum diagnostic workup
• Zubrod Performance Status 0-1
• Age > 18
• Adequate bone marrow function
• Adequate hepatic function
• Adequate renal function
• Pregnancy test within 4 weeks prior to registration for women of childbearing potential
• Women of childbearing potential and male participants must agree to use a medically effective means of birth control throughout their participation in the treatment phase of the study (until at least 60 days following the last study treatment)
• Patient must sign study specific informed consent prior to study entry.

Exclusion Criteria:

• Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years;
• Patients with simultaneous primaries or bilateral tumors are excluded.
• Patients who present with a cervical lymph node metastasis of unknown primary origin;
• Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable;
• Prior radiotherapy that would result in overlap of radiation therapy fields;
• Primary site of tumor of oral cavity, nasopharynx, nasal cavity, paranasal sinuses, or salivary glands;
• Recurrent head and neck cancer;
• Severe, active co-morbidity
• Pregnant or lactating women or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic.
• Prior allergic reaction to the study drug(s) involved in this protocol.