Inclusion Criteria:

- Patients must have primary or recurrent advanced-stage (III/IV) squamous cell
carcinoma of the skin of the face, ear, scalp or neck or of the lip

- A biopsy or preserved representative tumor block is required to confirm the diagnosis

- Patients must be surgical candidates with resectable disease; macroscopic complete
resection of all tumor must be planned with curative intent

- Patients must be willing to receive postoperative radiation therapy and treatment
with study drugs

- Both men and women and members of all races and ethnic groups will be included

- Life expectancy of greater than 12 months

- Eastern Cooperative Oncology Group (ECOG) performance status =< 2

- Absolute neutrophil count >= 1,500/uL

- Hemoglobin >= 9 g/dL

- Platelets >= 100,000/uL

- International normalized ratio (INR) < institutional upper limit of normal (ULN)

- Total bilirubin =< 1.5 x institutional ULN

- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase
[SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT])
=< 2.5 X institutional ULN

- Creatinine =< 1.5 X institutional ULN

- Fasting blood glucose < 125 mg/dL at baseline

- Patients-both males and females-with reproductive potential (i.e., menopausal for
less than 1 year and not surgically sterilized) must practice effective contraceptive
measures throughout the study; women of childbearing potential must provide a
negative pregnancy test (serum or urine) within 14 days prior to registration

- Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

- Patients with known distant metastasis

- Patients who have had prior radiation treatment of the index cancer or area of
disease

- Patients who have received any other investigational medication within 6 weeks of
enrollment, or who are scheduled to receive an investigational drug during the course
of the study

- Prior treatment with EGFR inhibitor for index cancer

- Prior treatment with an IGF-1R antagonist (small molecule inhibitor or antibody)

- Breast-feeding, pregnancy or of childbearing potential (including less than two years
postmenopausal) and unable to confirm adequate contraception due to possible risk to
fetus or infant

- Insulin-dependent and non-insulin dependent diabetes mellitus including any metformin
or insulin use on an ongoing basis prior to enrollment

- Known severe hypersensitivity to erlotinib, other small molecule inhibitors of EGFR,
or its excipients

- Hepatitis B or C infection (acute or chronic), known human immunodeficiency virus
(HIV), or active uncontrolled infection, because of possible risk of lethal infection
when treated with marrow suppressive therapy

- History of uncontrolled cardiac disease such as unstable angina pectoris, myocardial
infarction within prior 6 months, untreated coronary artery disease, uncontrolled
congestive heart failure, or cardiomyopathy with decreased ejection fraction

- Uncontrolled peptic or gastric ulcer disease or gastrointestinal bleeding within
prior 6 months

- Corrected QT interval (QTc) > 450 msec; congenital long QT syndrome or previous
history of QTc prolongation as a result from other medication

- Presence of left bundle branch block (LBBB); QTc with Bazett's correction that is
unmeasurable, or >= 450 msec on screening electrocardiogram (EKG)

- Any concomitant medication that may cause QTc prolongation or concomitant medication
that is associated with Torsades de Pointes

- Psychiatric illness/social situations that would limit compliance with study
requirements

- Active smokers unwilling to quit smoking during treatment

- Use of the potent cytochrome P450 3A4 (CYP3A4) and cytochrome P450 1A2 (CYP1A2)
inhibitors is not allowed; other less potent CYP3A4 and CYP1A2 inhibitors/inducers
are not excluded

- Participation in another investigational trial while on this study is not allowed

- History of poorly controlled gastrointestinal disorders including acute
diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, Crohn's
disease, ulcerative colitis or other diseases which have the potential for bowel
perforation

- Other malignancies except for resected cervical cancer in situ