Study of Olaparib With Radiation Therapy and Cetuximab in Advanced Head and Neck Cancer With Heavy Smoking History

Inclusion Criteria

• •1. Provision of fully informed consent prior to any study specific procedures.
• •2. Patients must be \> 18 years of age.
• •3. Histologically or cytologically confirmed (from the primary lesion and/or regional lymph nodes) squamous cell carcinoma of the oropharynx, hypopharynx, or larynx that has not been previously treated or resected
• •4. Stage IV A or stage IV B disease prior to induction chemotherapy with no proven hematogenous metastatic disease (includes T4aN0-1M0, T1-4aN2M0, T4b, any N, M0 or any T, N3M0)
• •5. History of ≥ 10 pack-years of smoking cigarettes.
• •6. Patients must have normal organ and bone marrow function measured within 28 days prior to administration of study treatment as defined below:
• •* Hemoglobin ≥ 9.0 g/dL
• •* Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
• •* White blood cells (WBC) \> 3x109/L
• •* Platelet count ≥ 100 x 109/L
• •* Total bilirubin ≤ 1.5 x institutional upper limit of normal
• •* Aspartate Aminotransferase(AST) (SGOT)/Alanine Aminotransferase (ALT) (SGPT) ≤ 2.5 x institutional upper limit of normal unless liver metastases are present in which case it must be ≤ 5x ULN
• •* Serum creatinine ≤ 1.5 x institutional upper limit of normal (ULN)
• •* Creatinine clearance (CCr) ≥ 50 ml/min within 2 weeks prior to registration as determined by 24-hour collection or estimated by Cockcroft-Gault formula:
• •CCr male = \[(140 - age) x (wt in kg)\]/ \[(Serum Cr mg/dl) x (72)\] CCr female = 0.85 x (CrCl male)
• •7. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (see Appendix F)
• •8. Patients must have a life expectancy ≥ 16 weeks.
• •9. Evidence of non-childbearing status for women of childbearing potential, or postmenopausal status: negative urine or serum pregnancy test within 28 days of study treatment, confirmed prior to treatment on day 1
• •Postmenopausal is defined as:
• •* Amenorrheic for 1 year or more following cessation of exogenous hormonal treatments,
• •* luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in the post menopausal range for women under 50,
• •* radiation-induced oophorectomy with last menses \>1 year ago,
• •* chemotherapy-induced menopause with \>1 year interval since last menses,
• •* or surgical sterilisation (bilateral oophorectomy or hysterectomy).
• •10. Patient is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations.
• •11. At least one lesion prior to induction chemotherapy, not previously irradiated, that can be accurately measured at baseline as ≥ 10 mm in the longest diameter (except lymph nodes which must have short axis ≥ 15 mm) with computed tomography (CT), magnetic resonance imaging (MRI) or clinical examination (for instance, palpable lymph node in neck) and which is suitable for accurate repeated measurements.
• •Patients with measurable disease prior to induction Docetaxel, Cisplatin and 5-fluorouracil (TPF) chemotherapy who obtain a complete clinical response prior to assignment to protocol therapy (RT + C225 + Olaparib) are still eligible for enrollment.
• •12. If formalin fixed, paraffin embedded tumor sample from biopsy exists, it should be available for testing. For inclusion in genetic research (analysis of biologic marker expression), patients must fulfill the following criterion:
• •Provision of informed consent for genetic (biomarker) research (If a patient declines to participate in the research, there will be no penalty or loss of benefit to the patient. The patient will not be excluded from other aspects of the study described in this Clinical Study Protocol, so long as they consent to that part.)