Chemotherapy and Radiation Therapy (RT) With or Without Vandetanib in Treating Patients With High-Risk Stage III or Stage IV Head and Neck Cancer

DISEASE CHARACTERISTICS:

   - Histologically or cytologically confirmed squamous cell carcinoma of the head and
   neck, including any of the following subtypes:

      - Oral cavity

      - Oropharynx

      - Larynx

      - Hypopharynx

   - Stage III or IV disease (no distant metastases)

   - No cancer of the lip, nasopharynx, or sinuses

   - Must have undergone gross total resection* (with curative intent) within 3-6 weeks of
   registration, with pathology demonstrating 1 or more of the following risk factors:

      - Histologic extracapsular nodal extension

      - Invasive cancer seen on microscopic evaluation of the resection margin, when all
      visible tumor has been removed NOTE: *Tonsillar cancer patients who undergo
      transoral excision of all gross tumor are eligible if the patient has formal neck
      dissection confirming histologic extracapsular nodal extension

PATIENT CHARACTERISTICS:

Inclusion criteria:

   - Zubrod performance status 0-1

   - ANC (absolute neutrophil count) ≥ 2,000/mm³

   - Platelet count ≥ 100,000/mm³

   - Hemoglobin ≥ 8.0 g/dL (transfusion or other intervention to achieve this level
   allowed)

   - Total bilirubin normal

   - AST (aspartate aminotransferase) or ALT (alanine amino transferase) ≤ 2 times upper
   limit of normal (ULN)

   - Alkaline phosphatase ≤ 2.5 times ULN

   - Serum creatinine ≤ 1.5 mg/dL

   - Creatinine clearance ≥ 60 mL/min

   - Glucose ≥ 40 mg/dL AND ≤ 250 mg/dL

   - Sodium ≥ 130 mmol/L AND ≤ 155 mmol/L

   - Magnesium ≥ 0.9 mg/dL AND ≤ 3 mg/dL (supplementation allowed)

   - Potassium ≥ 4 mmol/L AND ≤ 6 mmol/L (supplementation allowed)

   - Serum calcium (ionized or adjusted for albumin) ≥ 7 mg/dL AND ≤ 12.5 mg/dL
   (supplementation allowed)

   - QTc (corrected QT interval) interval ≥ 480 msec must have 2 additional EKGs ≥ 24 hrs
   apart and the average QTc from the 3 screening EKGs must be < 480 msec

   - Not pregnant or nursing

   - Negative pregnancy test

   - Fertile patients must use effective contraception during and for at least 60 days
   after completion of study treatment

   - May not donate blood during the study or for 3 months after last dose of vandetanib

Exclusion criteria:

   - Other simultaneous primary cancer

   - Prior invasive malignancy (except nonmelanoma skin cancer) unless disease free for a
   minimum of 3 years with the exception of the following:

      - Carcinoma in situ of the cervix

      - Adequately treated basal cell or squamous cell carcinoma of the skin

      - Untreated or treated low-risk prostate cancer (defined as clinical or pathologic
      T1c, N0 M0, PSA (prostate-specific antigen) < 10, Gleason < 7, < 50% of the total
      cores positive for cancer)

   - Severe, active co-morbidity, defined as follows:

      - Clinically significant cardiovascular event (e.g., myocardial infarction,
      superior vena cava syndrome, or New York Heart Association class II-IV) or
      presence of cardiac disease that, in the opinion of the investigator, increases
      the risk of ventricular arrhythmia within the past 3 months

      - Unstable angina and/or congestive heart failure requiring hospitalization within
      the past 3 months

      - Transmural myocardial infarction within the past 3 months

      - History of arrhythmia (e.g., multifocal premature ventricular contractions,
      bigeminy, trigeminy, ventricular tachycardia, or uncontrolled atrial
      fibrillation) which is symptomatic or requires treatment (CTCAE [Common
      Terminology Criteria for Adverse Events] grade 3), or asymptomatic sustained
      ventricular tachycardia

         - Patients with atrial fibrillation, controlled on medication, are eligible

      - Presence of left bundle branch block

      - Previous history of QTc prolongation as a result from other medication that
      required discontinuation of that medication

      - Congenital long QTc syndrome or first degree relative with unexplained sudden
      death under 40 years of age

      - QTc with Bazett's correction that is unmeasurable or ≥ 480 msec on screening EKG

         - Patients who are receiving a drug that has a risk of QTc prolongation are
         not eligible if QTc is ≥ 460 msec

      - Hypertension (systolic blood pressure [BP] > 160 mm Hg or diastolic BP > 100 mm
      Hg) not controlled by medical therapy

      - Diarrhea ≥ grade 1 (increase of < 4 stools per day over baseline or mild increase
      in ostomy output compared to baseline)

      - Acute bacterial or fungal infection requiring intravenous antibiotics at the time
      of registration

      - Chronic obstructive pulmonary disease exacerbation or other respiratory illness
      requiring hospitalization or precluding study therapy within the past 30 days

      - Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects

      - Acquired Immune Deficiency Syndrome (AIDS) based upon current CDC (Center for
      Disease Control) definition (no HIV testing is required for study entry)

   - Prior allergic reaction to cisplatin or vandetanib or derivatives similar to these
   drugs

PRIOR CONCURRENT THERAPY:

   - See Disease Characteristics

   - No prior systemic chemotherapy for this disease (prior chemotherapy for a different
   cancer allowed)

   - No prior radiotherapy to the head and neck area that would result in overlap of
   radiotherapy fields

   - More than 30 days since prior investigational agents

   - More than 3 weeks since prior major surgery and recovered

   - More than 2 weeks since prior and no concurrent medications that induce Torsades de
   Pointes

   - More than 2 weeks since prior and no concurrent known potent inducers of CYP3A4
   (Cytochrome P450 3A4), including rifampicin, phenytoin, carbamazepine, barbiturates,
   and Hypericum perforatum (St. John wort)

   - No concurrent medication that may cause QTc prolongation