Topotecan in Treating Patients With Recurrent Extensive-Stage Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

Histologically confirmed small cell lung cancer (SCLC)

Recurrent extensive stage disease
No mixed histology

Measurable disease

At least 1 bidimensionally measurable, non-central nervous system (CNS), indicator lesion confirmed by CT scan or MRI

Sensitive disease

Responded to prior first-line therapy AND relapsed ≥ 60 days after response (90 days after initiation of first-line therapy)
Eligible for high-dose chemotherapy
No symptomatic brain metastases affecting performance status

PATIENT CHARACTERISTICS:

Age

18 and over

Performance status

Eastern Cooperative Oncology Group (ECOG) 0-2

Life expectancy

At least 2 months

Hematopoietic

Absolute neutrophil count ≥ 1,500/mm^3
Platelet count ≥ 100,000/mm^3
Hemoglobin ≥ 9.0 g/dL
Hematocrit > 35% (without transfusion)

Hepatic

Serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) ≤ 2 times normal*
Alkaline phosphatase ≤ 2 times normal*
Bilirubin ≤ 2.0 mg/dL
Albumin > 2.5 g/dL
Hepatitis B surface antigen negative
No significant hepatic disease Note: *≤ 5 times upper limit of normal if liver metastases are present

Renal

Creatinine clearance ≥ 40 mL/min

Cardiovascular

No history of cardiac arrhythmias
No congestive heart failure
No ischemic heart disease
No stroke or other embolic disease requiring daily treatment that would preclude study participation

Other

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception during and for 3 months after study participation
HIV negative
No known seizure disorder
No active infection requiring systemic therapy within the past 2 weeks
No known hypersensitivity to topotecan hydrochloride
No medical or psychiatric condition that would preclude study participation
No other malignancy except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, or stage A low-grade prostate cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy

Not specified

Chemotherapy

See Disease Characteristics
More than 4 weeks since prior antineoplastic and/or myelosuppressive chemotherapy
No more than 1 prior chemotherapy regimen (except for adjuvant chemotherapy) for SCLC
No prior topotecan hydrochloride

Endocrine therapy

Not specified

Radiotherapy

Not specified

Surgery

Not specified

Other

More than 2 months since prior investigational agent
No other concurrent investigational agent