You'd have to get the T-nut to bind up and the cam to rotate against the work at exactly the same time. Otherwise either the nut will just move in the slot or you won't be able to turn the screw far enough to engage the cam because it will tight in the nut.
So is this why the t slot clamps have a set screw in the t-nut? You would then position the t-nut, tighten the setscrew so that the t-nut doesn't move, then tighten the cam screw to secure the work, correct? I was wondering what that set screw was for...