Phase II Trial of HM781-36B in Patients With Metastatic/Recurrent Head and Neck Squamous Cell Carcinoma (HNSCC) After Failure of or Unfit for Platinum-containing Therapy

Inclusion Criteria:

1. Histologically confirmed squamous cell carcinoma of head and neck
2. Age ≥ 20 years
3. ECOG PS 0-1

   * Documented progressive disease after platinum-based (either cisplatin or carboplatin) concurrent chemoradiation including induction chemotherapy for curative aim or
   * Documented progressive disease after platinum-based (either cisplatin or carboplatin) chemotherapy for palliative aim or
   * Ineligible to platinum-based (either cisplatin or carboplatin) chemotherapy or chemoradiation due to decline in renal function and patient's intolerance
4. At least one bidimensionally measurable disease as defined by RECIST ver 1.1
5. Adequate organ function for treatment

   * Absolute neutrophil count (ANC) ≥ 1000cells/mm3
   * Platelets ≥ 100000 cells/mm3
   * Estimated creatinine clearance ≥ 50mL/min, or serum creatinine \< 1.5 x institution upper limit of normal
   * Bilirubin ≤ 1.5 x upper limit of normal(ULN)
   * AST(SGOT) ≤ 2.5 x ULN (5.0xULN if hepatic metastases)
   * ALT(SGPT) ≤ 2.5 x ULN (5.0xULN if hepatic metastases)
6. The patient has provided signed informed consent and is amenable to compliance with protocol schedules and testing

Exclusion Criteria:

1. Nasopharyngeal carcinoma
2. Patients who are subjected to local treatment (surgery or radiation)
3. Previous treatment with small molecule EGFR tyrosine kinase inhibitors (Cetuximab is permitted)
4. Three or more previous systemic cytotoxic chemotherapy
5. Any major operation or irradiation within 4 weeks of baseline disease assessment
6. Patients who have received prior systemic chemotherapy, immunotherapy or study drug within 4 weeks
7. Any clinically significant gastrointestinal abnormalities which may impair intake or absorption of the study drug
8. Patients with uncontrolled CNS metastatic involvement. However, patients with metastatic CNS tumors may participate in this study if the patient is clinically stable not receiving steroid therapy more than 1 week from prior therapy completion (including radiation and/or surgery) to stating the study drug.
9. Patients with known interstitial lung disease (ILD) or presented ILD on screening chest X-ray
10. Congenital long QT syndrome or screening corrected QT interval (QTc) \> 470msec
11. Patients with uncontrolled or significant cardiovascular disease (AMI within 12 months, Unstable angina within 6 months, NYHA Class III, IV Congestive heart failure or left ventricular ejection fraction below local institutional lower limit of normal or below 45%, Congenital long QT syndrome, Any significant ventricular arrhythmia, Any uncontrolled second or third degree heart block, Uncontrolled hypertension)
12. Previous or concurrent malignancy except for basal or squamous cell skin cancer and/or in situ carcinoma of the cervix, or other solid tumors treated curatively and without evidence of recurrence for at least 3 years prior to study entry.
13. Pregnant or breast-feeding women
14. Other severe acute or chronic medical condition or laboratory abnormality that may increase the risk associated with trial participation or investigational product administration or may interfere with the interpretation of trial results and, in the judgment of the investigator, would make the patient inappropriate for entry into this trial.