eligibility_summary
Adults (≥18) with path-confirmed, HPV‑negative, stage III–IV, non‑metastatic head & neck SCC (oral cavity/oropharynx/hypopharynx/nasopharynx/larynx/sinuses), measurable disease, ECOG 0–1, adequate organ function, no prior HN chemo/RT, residual tumor, ≥10 unstained slides or new biopsy, consent, contraception, not pregnant/breastfeeding. Exclude: M1, unknown primary, serious comorbidity/immunodeficiency/steroids, investigational agents, recent systemic therapy, cetuximab allergy, active TB/HBV/HCV, HIV, recent live vaccine, other active cancer.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Drugs/interventions: Induction paclitaxel (taxane, stabilizes microtubules → mitotic arrest), carboplatin (platinum, DNA crosslinker), cetuximab (chimeric IgG1 anti‑EGFR mAb, blocks EGFR signaling and mediates ADCC). Response‑adaptive chemoradiation: low‑ vs standard‑dose radiation (induces DNA double‑strand breaks) plus either cisplatin (platinum DNA crosslinker, radiosensitizer) or TFHX (paclitaxel + 5‑FU + hydroxyurea, 5‑FU inhibits thymidylate synthase, hydroxyurea inhibits ribonucleotide reductase). Cells/pathways targeted: rapidly dividing HPV‑negative HNSCC cells, EGFR‑driven signaling (RAS/RAF/MEK/ERK, PI3K/AKT), mitotic spindle microtubules, DNA replication/repair, nucleotide synthesis, radiation‑induced DNA damage responses, immune effector ADCC via NK cells. ctDNA is used as a biomarker to guide de‑escalation/escalation.