Paclitaxel, Cisplatin, and Cetuximab Followed By Cetuximab and Intensity-Modulated Radiation Therapy in Treating Patients With HPV-Associated Stage III or Stage IV Cancer of the Oropharynx That Can Be Removed By Surgery

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed squamous cell carcinoma of the oropharynx as determined by H&E staining

  • Newly diagnosed disease
  • Resectable disease OR disease that is expected to become resectable after study treatment
  • Stage III, IVA, or IVB disease as determined by imaging studies (CT scan with IV contrast or MRI required) and a complete head and neck exam

• Paraffin-embedded tumor specimen available for central confirmation of HPV-associated disease as determined by H&E staining and in-situ hybridization (ISH) for HPV-16 and IHC for p16

  • HPV-associated disease is defined as p16 IHC-positive and/or HPV-16 ISH-positive
  • Non-HPV-associated disease is defined as p16 IHC-negative
• NOTE: If there is limited tumor material, p16 IHC will be performed before HPV-16 ISH
• Measurable disease of the primary tumor or nodes by clinical and radiographic methods, defined as a lesion that is ≥ 2 cm in at least one dimension by clinical exam AND by radiographic exam with CT scan or MRI (or a lesion that is ≥ 1 cm in at least one dimension if the radiographic exam utilizes spiral CT scan)
• No primary tumor or nodal metastasis fixed to the carotid artery, skull base, or cervical spine
• No evidence of distant metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• Granulocytes ≥ 1,000/mm^3
• Platelet count ≥ 100,000/mm^3
• Total serum bilirubin ≤ 1.5 mg/dL
• Creatinine clearance ≥ 60 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No history of another malignancy (except for carcinoma in situ of the cervix and/or nonmelanomatous skin cancer) unless it has been curatively treated and the patient has been disease-free for ≥ 2 years

• Patients with any of the following within the past 6 months are eligible provided they have been evaluated by a cardiologist and/or neurologist before study entry:

  • NYHA class III-IV congestive heart failure
  • Cerebrovascular accident or transient ischemic attack
  • Unstable angina
  • Myocardial infarction (with or without ST elevation)
• No uncontrolled diabetes, uncontrolled infection despite antibiotics, or uncontrolled hypertension within the past 30 days
• No concurrent illness likely to interfere with study therapy or to prevent surgical resection
• No prior severe infusion reaction to a monoclonal antibody

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy
• No prior radiotherapy above the clavicles
• No prior surgery with curative intent for this disease (complete head and neck exam with biopsy allowed)
• No prior therapy specifically and directly targeting the EGFR pathway