Paclitaxel and Carboplatin With or Without Nitroglycerin in Treating Patients With Previously Untreated Stage III or Stage IV Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed non-small cell lung cancer

  * Stage IIIB or IV disease that cannot be treated by radical irradiation
* Tumor lesions must be objectively evaluated according to WHO criteria (maximum diameter is no shorter than twice the slice width and no shorter than 10 mm) by CT scan
* No brain metastasis

PATIENT CHARACTERISTICS:

* ECOG performance status 0-1
* Life expectancy ≥ 3 months
* Neutrophil count \> 2,000/μL
* Hemoglobin \> 10.0 g/dL
* Platelet count \> 100,000/μL
* Serum bilirubin \< 2.0 mg/dL
* ALT and AST \< 100 IU/L
* Serum creatinine \< 2.0 mg/dL
* PaO\_2 ≥ 70 mm Hg
* No cardiac problems, including any of the following:

  * Poorly controlled hypertension
  * Unstable angina
  * Congestive heart failure
  * Myocardial infarction within the past year
  * Ventricular arrhythmia that requires treatment except single, well-controlled isolated ventricular extrasystole
* No chronic active hepatitis or cirrhosis requiring treatment except hepatitis virus carriers who do not need treatment
* No comorbidity of interstitial pneumonia and pulmonary fibrosis requiring treatment
* No other cancer requiring treatment except a malignant tumor curatively resected with no recurrence
* No severe psychiatric disorders including schizophrenia or dementia
* Cardiothoracic ratio \< 60% by chest x-ray
* No history of severe drug allergy or allergy to polyoxyethylene castor oil (in some anesthetic drugs or muscle relaxants) or polysorbate 80
* Patients in whom nitroglycerin preparations are contraindicated are not eligible, including any of the following:

  * Severe hypotension (e.g., systolic blood pressure ≤ 80 mm Hg)
  * Angle-closure glaucoma
  * History of hypersensitivity to nitrate/nitrite ester drugs
* Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

* No prior chemotherapy or radiotherapy

  * Pleurodesis is not considered chemotherapy
* At least 1 week since prior and no other concurrent nitric oxide donors (e.g., nitroglycerin)
* At least 1 week since prior and no concurrent calcium antagonists
* At least 1 week since prior and no concurrent drugs for erectile dysfunction that inhibit phosphodiesterase 5 (e.g., sildenafil citrate or vardenafil hydrochloride hydrate)
* More than 24 hours since prior and no concurrent administration of the following:

  * Antifungal azoles, including ketoconazole, miconazole, or itraconazole
  * Macrolides, including erythromycin or clarithromycin
  * Cyclosporines
  * Benzodiazepines, including diazepam, triazolam, or midazolam
  * Vitamin A
  * Steroid hormones, including ethinylestradiol
* No concurrent participation in another clinical trial