Fondaparinux (Arixtra) With Chemotherapy for Advanced Non-Small Cell Lung Cancer

Inclusion Criteria:

* Histologic or cytologic diagnosis of Non-Small Cell Lung Cancer.
* Stage IV Non-Small Cell Lung Cancer.
* Measurable or assessable tumor parameters according to RECIST criteria.
* ECOG Performance Status 0-2.
* Age between 18 and 79 years (in the State of Alabama \> 18).
* Adequate hematologic, coagulation, liver and renal function, defined as:
* Absolute neutrophil count (ANC) ≥ 1500/µL
* Platelet count ≥ 100,000/µL
* Serum Glutamic Oxaloacetic Transaminase(SGOT)/Serum Glutamic Pyruvic Transaminase(SGPT) ≤ 2.5 x upper limit of normal or ≤ 5 x upper limit of normal when liver metastases are present
* Total bilirubin value ≤ 1.5 x upper limit of normal
* Serum creatinine value ≤ 1.5 x upper limit of normal
* Normal prothrombin time and partial thromboplastin time
* Fully recovered from any previous surgery (at least 4 weeks since major surgery).
* Must have recovered from prior radiation therapy (at least 3 weeks).
* All participants must agree to practice approved methods of birth control (if applicable). A negative pregnancy test must be documented during the screening period for women of childbearing potential.
* Must provide written informed consent and authorization to use and disclose health information.
* No prior chemotherapy.

Exclusion Criteria:

* Active bleeding disorder.
* Evidence of hemoptysis. Patients with blood-tinged or blood-streaked sputum will be permitted on study if the hemoptysis amounts to less than 5 mL of blood per episode and less than 10 mL of blood per 24-hour period in the best estimate of the investigator.
* Previous history of Venous Thromboembolism (VTE) within 12 months and requiring active anticoagulation therapy.
* Concurrent cancer chemotherapy, biologic therapy or radiotherapy.
* Administration of any investigational drug within 28 days prior to administration of the current therapy.
* Symptomatic brain metastases; those patients should be treated first with either whole brain radiation therapy or radiosurgery and have stable disease.
* Concurrent serious infection.
* Concomitant severe or uncontrolled underlying medical disease unrelated to the tumor, which is likely to compromise patient safety and affect the outcome of the study.
* History of other malignancy (except non-melanoma skin cancer or carcinoma in situ of the cervix), unless in complete remission and off all therapy for a minimum of 2 years.
* Any evidence or history of hypersensitivity or other contraindications for the drugs used in this trial.
* Psychiatric disorder that prevents patients from providing informed consent or following protocol instructions.
* Pregnant or lactating women.
* Creatinine clearance \< 30 mL/min.
* Patient body weight \< 50 kg.