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