Randomized Phase II Trial of Carboplatin/Gemcitabine Followed By Paclitaxel or Cisplatin/Vinorelbine Followed by Docetaxel in Advanced Non-Small Cell Lung Cancer

Inclusion Criteria

DISEASE CHARACTERISTICS: Histologically confirmed newly diagnosed stage IIIB or IV
advanced primary non-small cell lung cancer (adenocarcinoma, large cell carcinoma,
squamous cell carcinoma, or unspecified) or recurrent non-small cell lung cancer after
previous surgery and/or radiotherapy Stage IIIB: T4 lesion due to malignant pleural
effusion, OR multiple lesions in a single lobe containing a T3 or T4 primary, OR lesions
in multiple lobes of the ipsilateral lung for which one such lesion is T3 or T4 Any N M0
Stage IV: Any T, Any N, M1 Measurable or evaluable disease Measurable or evaluable disease
must be outside of the prior radiotherapy port or prior surgical resection area No brain
metastases No bronchoalveolar carcinoma or stage IIIB tumor involving the superior sulcus
(pancoast tumors)

PATIENT CHARACTERISTICS: Age: 18 and over Performance status: SWOG 0-1 Life expectancy:
Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Creatinine no
greater than 2 times upper limit of normal AND Creatinine clearance at least 50 mL/min
Other: No prior malignancy in the past 5 years except adequately treated basal cell or
squamous cell skin cancer, carcinoma in situ of the cervix, or adequately treated stage I
or II cancer from which the patient is currently in complete remission Not pregnant or
nursing Effective contraception required of all fertile patients

PRIOR CONCURRENT THERAPY: Biologic therapy: No prior biologic therapy for non-small cell
lung cancer No concurrent biologic therapy to measurable or evaluable lesions
Chemotherapy: No prior systemic chemotherapy for non-small cell lung cancer Endocrine
therapy: No concurrent hormonal therapy to measurable or evaluable lesions Radiotherapy:
At least 3 weeks since prior radiotherapy and recovered No concurrent radiotherapy to
measurable lesions Palliative radiation to small field nonmeasurable sites of disease
(painful bony metastases) allowed Surgery: At least 3 weeks since surgery (thoracic or
other major surgeries) and recovered