Combination Chemotherapy in Treating Patients With Extensive-Stage Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed extensive stage small cell lung carcinoma (SCLC)
* No prior chemotherapy for SCLC OR
* No chemotherapy within 5 years of diagnosis of SCLC
* Prior radiotherapy to measurable or nonmeasurable disease field allowed provided radiotherapy was completed at least 6 weeks ago and the disease is demonstrated to be progressing
* No clinical signs or symptoms of brain and/or leptomeningeal metastases by CT scan or MRI

  * Brain and/or leptomeningeal metastases that are asymptomatic on neurologic exam are allowed provided metastases do not require corticosteroid therapy to control symptoms

PATIENT CHARACTERISTICS:

Age:

* 18 and over

Performance status:

* ECOG 0-2

Life expectancy:

* At least 3 months

Hematopoietic:

* Hemoglobin at least 9.0 g/dL
* WBC at least 3,500/mm3
* Platelet count at least 100,000/mm3
* Neutrophil count at least 1,500/mm3

Hepatic:

* Bilirubin no greater than 2.0 mg/dL
* SGOT and SGPT no greater than 2 times the upper limit of normal (ULN) (5 times ULN if liver metastases present)
* Alkaline phosphatase no greater than 2 times ULN (5 times ULN if liver metastases present)

Renal:

* Creatinine no greater than 1.5 mg/dL
* Creatinine clearance at least 60 mL/min
* No pre-existing renal impairment that would preclude cisplatin use

Gastrointestinal:

* No clinical evidence of any gastrointestinal (GI) conditions including:

  * Removal of a portion of the stomach
  * History of recent obstruction of the GI tract
  * GI autonomic neuropathy
  * Ulcerative colitis
  * Crohn's disease
  * Malabsorption syndrome
  * Treatment with cyclosporine that would alter absorption or GI motility
* No other conditions that would preclude absorption of oral topotecan

Other:

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception for 3 months prior to study, during, and for at least 1 month after study
* No active infection
* No other prior or concurrent malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or localized low-grade prostate cancer
* No other concurrent severe medical problems that would expose the patient to extreme risk or preclude study compliance
* No prior allergic reactions to compounds chemically related to study drugs
* No pre-existing hearing impairment that would preclude cisplatin use
* No overall medical condition for which study drugs would be inappropriate

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* No concurrent immunotherapy for SCLC

Chemotherapy:

* See Disease Characteristics
* No other concurrent chemotherapy for SCLC

Endocrine therapy:

* See Disease Characteristics
* No concurrent hormonal therapy for SCLC

Radiotherapy:

* See Disease Characteristics
* At least 24 hours since prior radiotherapy with no expected bone marrow suppression
* Recovered from prior palliative radiotherapy (e.g, nausea and vomiting from radiation of the epigastrium)
* No concurrent radiotherapy for SCLC
* No concurrent radiotherapy for palliation of bone metastases or CNS lesions unless approved by the investigator

Surgery:

* At least 3 weeks since prior major surgery (a shorter period is allowed if deemed in the best interest of the patient)

Other:

* More than 30 days or 5 half-lives (whichever is longer) since prior investigational drugs
* No other concurrent investigational therapy for SCLC
* No concurrent cyclosporine
* No concurrent drugs that would preclude absorption of oral topotecan