A phase I study afatinib/carboplatin/paclitaxel induction chemotherapy followed by standard chemoradiation in HPV-negative or high-risk HPV-positive locally advanced stage III/IVa/IVb head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) causes a significant morbidity worldwide with the incidence of approximately 550,000 cases per year [1]. The most common risk factors are tobacco use and human papillomavirus (HPV) infection [2,3]. At diagnosis, a majority of patients present with locally advanced disease, but patients with HPV-positive HNSCC have a more favorable survival compared to patients with HPV-negative HNSCC [4–6]. However, there is a clear interaction between tobacco use and HPV-related carcinogenesis reflected by the worse survival of patients with HPV-positive HNSCC and smoking history compared to non-smokers [6,7].

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