Approximately 30% of head and neck cancer patients have a recurrent amplification in the FADD/BIRC2 (IAP1) genes. Inhibitor of apoptosis protein 1 is inhibited by SMAC. Birinapant is a peptidomimetic of SMAC, which inhibits IAP1 and has been shown to induce cell death in cancer cells with the specific amplification. In this phase I trial, patients with locoregionally recurrent head and neck cancer who have been previously treated with radiotherapy and qualify for re-irradiation, will receive birinapant in combination with re-irradiation. This trial opened in March 2019 at the NIH and in June 2019 in a collaborating ETCTN center (Ohio State University). We are expecting accrual of 1 patient per month.
