Paclitaxel, Carboplatin, and Dimethylxanthenone Acetic Acid in Treating Patients With Extensive-Stage Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

* Histologically (preferred) or cytologically confirmed small-cell lung carcinoma (SCLC) by surgical biopsy, brushing, washing, OR core needle aspiration (sputum cytology alone not acceptable)

  * Extensive stage or stage IV disease, including patients with malignant pleural or pericardial effusion

    * No pleural effusion that causes ≥ CTC grade 2 dyspnea
* Not suitable for potentially curative combined-modality treatment for this disease
* Measurable or non-measurable disease
* No CNS metastases

PATIENT CHARACTERISTICS:

* WHO performance status 0-2
* Hemoglobin ≥ 10.0 g/dL
* Absolute neutrophils ≥ 2.0 x 10\^9/L (without the use of growth factors)
* Platelet count ≥ 100 x 10\^9/L
* Bilirubin ≤ 1.5 x the upper limit of normal (ULN)
* ALT ≤ 2.5 x ULN (≤ 5 x ULN if liver metastases)
* Alkaline phosphatase ≤ 2.5 x ULN (≤ 5 x ULN if liver metastases)
* Creatinine clearance ≥ 45 mL/min
* INR ≤ 1.5
* Magnesium, potassium, and calcium (corrected for albumin) normal
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception during and for 12 months after completion of study therapy
* No recent hemoptysis associated with SCLC (\> 1 teaspoon in a single episode within 4 weeks)
* No other malignancy within the past 5 years except for nonmelanoma skin cancer or cervical cancer in situ
* Must not have a history of any of the following conditions:

  * Myocardial infarction within the past 12 months
  * Uncontrolled hypertension (systolic BP \> 160 mm Hg and/or diastolic BP \> 90 mm Hg) or poor compliance with anti-hypertensive regimen
  * Sustained ventricular tachycardia
  * Ventricular fibrillation or Torsades de Pointes
  * Long QT syndrome
  * QTc of \> 450 msec
  * NYHA class III or IV congestive heart failure
  * Unstable or poorly controlled angina pectoris, including Prinzmetal variant angina pectoris
  * Right bundle branch block and left anterior hemiblock (bifascicular block)
  * Bradycardia (defined as heart rate \< 50 beats per minute)
  * Cardiac arrhythmias (i.e., symptomatic, but may not require medications) CTCAE grade ≥ 2
* No significant neurologic or psychiatric disorder that would compromise study participation
* No peripheral sensory neuropathy with functional impairment ≥ CTC grade 2 (regardless of cause)
* No concurrent severe and/or uncontrolled medical disease, including any of the following:

  * Uncontrolled diabetes
  * Chronic renal disease
  * Chronic liver disease
  * Confirmed diagnosis of HIV infection
  * Active uncontrolled infection
* No serious underlying medical condition, in the judgment of the investigator, that would impair the patient's ability to participate in the trial
* No known hypersensitivity to study drugs or to any other component of the study drugs (taxanes or other drugs formulated in Cremophor EL \[polyoxyethylated castor oil\])

PRIOR CONCURRENT THERAPY:

* Recovered from all prior therapy
* No prior systemic chemotherapy, immunotherapy, or biologic anti-cancer therapy
* More than 2 weeks since prior and no concurrent radiotherapy

  * Localized palliative radiotherapy to symptomatic bone metastases allowed
* More than 2 weeks since minor surgery

  * Insertion of a vascular access device allowed
* More than 3 weeks since prior dimethylxanthenone acetic acid for prophylactic cranial irradiation
* More than 4 weeks since major surgery (defined by the use of general anesthesia)
* At least 30 days since prior and no other concurrent investigational drugs or anti-cancer therapy
* No treatment in a clinical trial within 30 days prior to trial entry
* No concurrent therapy with a risk of causing Torsades de Pointes
* No concurrent drugs that would be contraindicated for use with study drugs
* No factors with the potential to prolong QT interval