Pioglitazone Hydrochloride in Treating Patients With Stage IA-IIIA Non-small Cell Lung Cancer

Inclusion Criteria:

Suspected or biopsy-proven NSCLC
Willingness to provide biopsy tissue for correlative studies
Candidate for pulmonary resection; must be able to schedule >= 14 days and =< 42 days between registration and surgery to allow for treatment with pioglitazone
Ability to understand and the willingness to sign a written informed consent document
Ability and willingness to swallow oral tablets

Ability and willingness to undergo two bronchoscopies (before treatment and at the time of surgery)

For those participants who are undergoing mediastinoscopy as part of their standard-of-care, the pre-treatment bronchoscopy may be performed during the mediastinoscopy; if the participant remains eligible for definitive surgical resection after the mediastinoscopy, the participant may proceed to registration and pioglitazone treatment
Current or former smoker with a >= 10 pack-year smoking history
Women of child-bearing potential and men who agree to use adequate contraception for the duration of study participation; women must not be pregnant or lactating; women of child-bearing potential (women considered not of childbearing potential if they are at least two years postmenopausal and/or surgically sterile) must have used adequate contraception (abstinence; barrier methods such as intrauterine device [IUD], diaphragm with spermicidal gel, condom, or others; and hormonal methods such as birth control pills or others) since her last menses prior to study entry; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately

Exclusion Criteria:

Receiving any other investigational agents
History of allergic reactions attributed to compounds of similar chemical or biologic composition to pioglitazone
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Pregnant or lactating woman
Currently treated diabetes
Participants with >= class II New York Heart Association (NYHA) congestive heart failure or history of congestive heart failure
Participants with >= grade 2 (moderate) edema
Participants currently receiving an inhibitor of cytochrome P450 family 2, subfamily C, polypeptide 8 (CYP2C8) (gemfibrozil, ketoconazole, quercetin, trimethoprim), or an inducer of CYP2C8 (cortisol, dexamethasone, phenobarbital, rifampin), or cytochrome P450 family 3, subfamily A, polypeptide 4 (CYP3A4) substrate
Prior neoadjuvant therapy for NSCLC
History of bladder cancer or in situ bladder cancer