Inclusion Criteria:

- Histologically or cytologically confirmed squamous cell carcinoma of the head and
neck; patient must not have nasopharyngeal carcinoma of histologic types WHO 2 and 3

- Metastatic or locally recurrent carcinoma of the head and neck that is considered
incurable by local therapies

- Any number of prior chemotherapy or biologic/targeted therapy regimens is allowed

- No prior therapy with docetaxel at any time (even if part of prior curative treatment

- No prior systemic EGFR inhibitors, such as ZD1839 (Iressa, gefitinib)/Iressa
(AstraZeneca), ABX-EBX (Abgenix), MDX-447 (Medarex/Merck), OSI-774/Tarceva (OSI
pharmaceuticals), C225/Cetuximab (ImClone), PKI166 (Novartis), CI-1033 (Parke-Davis),
EKB-569 (Wyeth Ayerst); treatment with paclitaxel is allowed if the patient did not
progress while on paclitaxel

- NOTE: the use of cetuximab given concurrently with radiation or
chemoradiotherapy for up to 9 total weekly doses, as part of initial potentially
curative therapy is allowed, if completed > 6 months prior to registration

- Patients must not be receiving any other investigational agent while on the study

- Patients must have either:

- Strata A:

- ECOG performance status 2 (in bed 50% of the time. Ambulatory and capable
of all self-care, but unable to carry out any work activities; up and about
more than 50% of waking hours), AND no prior chemotherapy for recurrent
metastatic head and neck cancer OR

- Strata B

- PS 0-2 AND prior chemotherapy (i.e. one or more prior chemotherapy regimens
(without docetaxel)) for locally recurrent/metastatic disease or exposure
to prior chemotherapy (without docetaxel) as part of primary curative
therapy < 6 months prior to randomization; patients who receive
chemotherapy as part of potentially curative therapy of primary disease
within 6 months of randomization will be considered as having prior
chemotherapy for recurrent/metastatic disease, whereas patients who
received chemotherapy as part of potentially curative therapy of disease >
6 months of randomization will be considered as having no prior
chemotherapy for recurrent/metastatic disease

- Patients must have fully recovered from the effects of any prior surgery,
chemotherapy, or radiation therapy

- A minimum time period of 3 weeks must elapse between the completion of radiation
therapy and randomization to the study

- A minimum period of 4 weeks must elapse between the last administration of any
prior chemotherapy and randomization to the study

- At least 2 weeks must elapse between the last administration of
biologic/targeted therapy and randomization to the study

- Patients must be > 3 weeks since major surgery, or significant traumatic injury
prior to randomization

- No unstable systemic disease, including active infection, uncontrolled hypertension,
unstable angina, congestive heart failure, or serious arrhythmia requiring medication

- Absolute neutrophil count (ANC) >= 1500 /mm^3

- Platelets >= 100,000 /mm^3

- Hemoglobin >= 8.0 g/dl

- Bilirubin within normal limits

- Alkaline phosphatase, SGOT (AST), and SGPT

- Creatinine < 2.0 or creatinine clearance of > 60 ml/min

- No hypercalcemia related to head and neck cancer

- No known brain metastasis

- Females should not be pregnant or breast feeding because chemotherapy may be harmful
to the fetus or the nursing infant; also, the effects of ZD1839 (Iressa, gefitinib)
on the developing human fetus are unknown

- All females of childbearing potential must have a blood test or urine study within 2
weeks prior to randomization to rule out pregnancy

- Women of childbearing potential and sexually active males must use an accepted and
effective method of contraception while on treatment and for three months after the
completion of treatment

- Patients must have measurable or non-measurable disease based on RECIST; baseline
measurements and evaluations must be obtained < 4 weeks of randomization; all areas
of disease should be recorded and mapped out in order to assess response and
uniformity of response to therapy; disease in previously irradiated sites is
considered measurable if there has been unequivocal disease progression or
biopsy-proven residual carcinoma following radiation therapy; persistent disease
after radiotherapy must be biopsy proven at least 8 weeks after completion of
radiation therapy

- Radiographic findings are acceptable providing that clear-cut measurements can
be made

- Patients with a prior history of squamous cell or basal carcinoma of the skin or in
situ cervical cancer must have been curatively treated. Patients with a history of
other prior malignancy must have been treated with curative intent and must have
remained disease-free for 5 years post diagnosis

- No current peripheral neuropathy >= grade 2 at time of randomization

- Patients must not have any co-existing condition that would preclude full compliance
with the study

- No known hypersensitivity to ZD1839 (Iressa, gefitinib) or any excipients of this
product; no prior history of severe hypersensitivity reaction to Docetaxel or other
drugs formulated with polysorbate 80

- Drugs that are CYP3A4 inhibitors should be generally avoided and if possible,
discontinued, 1 week prior to initiating study drug; however, if medically necessary,
they can be taken with caution after consulting with the study chair

- From patients consenting to participate in the correlative studies:

- Tissues must be submitted as outlined in Section 10; if tissue cannot be
submitted, written justification must be submitted to the ECOG Pathology
Coordinating Office

- HIV positive patient's receiving combination anti-retroviral therapy are excluded
from the study because of possible pharmacokinetic interactions with ZD1839 (Iressa,
gefitinib)

- Patients may not have had tumor-related hemorrhagic events in the previous three
months that required as major medical intervention, such as surgery or embolization

- Patients must not be on therapeutic anticoagulation or have tumors that are
unequivocally invading major vessels (e.g. carotid artery)