Reduced-intensity Therapy for Advanced Oropharyngeal Cancer in Non-smoking Human Papilloma Virus (HPV)-16 Positive Patients

These measures will be compared to the investigators historical control group (consisting of
non-smoking patients with advanced oropharyngeal cancer who received standard-intensity
chemo-radiation therapy and were evaluated by the same tools on UMCC protocol 2-21, IRB #
2002-513). Strict stopping rules will be enacted to ensure that reducing treatment intensity
does not increase tumor failures compared with the investigators previous results using
standard therapy.

Inclusion Criteria:

- pathologically-confirmed, previously untreated, stage IIIIV(excluding N3) squamous
cell carcinoma of the oropharynx, without evidence of distant metastasis

- Pretreatment tumor biopsy with sufficient tumor for HPV analysis is required. The
tumor must be HPV(+)/p16(+)

- Never smokers (including cigarettes, cigars, pipes, chewing tobacco, and/or
marijuana)

- Karnofsky Performance Status (KPS) > 80

- pre-treatment endoscopic tumor staging and PET-CT scanning

- appropriate lab levels and creatinine clearance

Exclusion Criteria:

- Prior head and neck malignancy or history of other prior non-head and neck malignancy
(excluding skin cancer and early stage treated prostate cancer) within the past 3
years

- Prior head and neck radiation or chemotherapy

- Any medical or psychiatric illness, which in the opinion of the principal
investigator,would compromise the patient's ability to tolerate this treatment or
limit compliance with study requirements

- prisoners

- Patients with prior anti-epidermal growth-factor receptor antibody therapy (antibody
or small molecule)