Head and Neck Cancer Study Project in the Geriatric Population

Inclusion Criteria

• •Patients must have the following
• •Pathology confirmed squamous cell carcinoma of the head and neck (unknown primary is excluded).
• •Confirmed stage of disease between IB and IVA, based on imaging studies.
• •CGA score of 3-5
• •Evaluation by medical oncology and radiation oncology.
• •Patients in the experimental group must be eligible for systemic treatment with chemoimmunotherapy followed by radiation treatment as determined by the geriatric oncology team.
• •Age ≥ 65 years.
• •ECOG performance status ≤ 2
• •Adequate organ and marrow function as defined below:
• •Absolute neutrophil count ≥1.0 x 109/L Platelets \>100,000/mm3 Total bilirubin \<1.5 x ULN Aspartate aminotransferase (ast/sgot) \<3 x ULN Alanine aminotransferase (alt/sgpt) \<3 x ULN Creatinine clearance ≥ 40 mL/min as determined by Cockcroft Gault (using actual body weight) or \<1.5 x Upper limit of normal
• •Males:
• •CLcr (mL/min) = "\[140 - age (years)\] × weight (kg)" /"72 × serum creatinine (mg/dL)"
• •Females:
• •(CLcr (mL/min) = "\[140 - age (years)\] × weight (kg)" /"72 × serum creatinine (mg/dL)" × 0.85
• •Patients receiving pembrolizumab must meet standard institutional criteria for immunotherapy including no history of severe autoimmune disease.
• •Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial.
• •For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated.