 All patients should have baseline tumor tissue available for EGFR determination therapeutic target of cetuximab and biomarker studies. Patients without available tissue at baseline may undergo tumor biopsy. Patients who provide consent and have accessible tumors will have a repeat biopsy 14 days an interval between 12-16 days is acceptable post initiation of therapy. Priority for study entry will be given to patients with easily accessible tumor and who consent to repeat biopsy. Study entry will not be restricted to patients who agree to further biopsies. If a patient enrolls on study and later refuses biopsy excluding diagnostic, heshe may remain on study. 