Pemetrexed Disodium and Either Cisplatin or Carboplatin in Treating Patients With Extensive-Stage Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed small cell lung cancer (SCLC)

  • Extensive stage, including malignant pleural effusion

• Measurable disease

  • At least 1 unidimensionally measurable lesion at least 20 mm by conventional techniques or 10 mm by spiral CT scan*

    • Chest x-rays are acceptable if the lesions are clearly defined and surrounded by aerated lung
    • Clinically detected lesions must be superficial (e.g., skin nodules or palpable lymph nodes) to be considered measurable
    • Skin lesions are to be documented by color photography, including a ruler to estimate the size of the lesion NOTE: *A solitary measurable lesion must be histologically or cytologically confirmed
• No symptomatic brain metastases
• No clinically relevant third-space fluid collections (e.g., ascites or pleural effusions) by physical examination that cannot be controlled by drainage or other procedures

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-2

Life expectancy

• At least 12 weeks

Hematopoietic

• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• Hemoglobin at least 9 g/dL

Hepatic

• Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• AST and ALT no greater than 3.0 times ULN*
• Alkaline phosphatase no greater than 3.0 times ULN* NOTE: *5 times ULN if liver has tumor involvement

Renal

• Creatinine clearance at least 45 mL/min

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 3 months after study treatment
• Able and willing to take folic acid, cobalamin (vitamin B_12), or dexamethasone
• Able to tolerate interruption of aspirin or other nonsteroidal anti-inflammatory agents for a 5-day period (8-day period for long-acting agents such as piroxicam)

• No second primary malignancy except the following:

  • Carcinoma in situ of the cervix
  • Adequately treated nonmelanoma skin cancer
  • Prior low-grade (Gleason score no greater than 6) localized prostate cancer
  • Other previously treated malignancy with no evidence of recurrence within the past 5 years
• No active infection
• No other serious concurrent systemic disorder that would preclude patient safety or study completion

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior systemic biologic therapy for SCLC
• No prior systemic immunotherapy for SCLC
• No concurrent prophylactic filgrastim (G-CSF)
• No concurrent thrombopoiesis stimulators
• No concurrent immunotherapy

Chemotherapy

• No prior systemic chemotherapy for small cell lung cancer
• No prior pemetrexed disodium
• No other concurrent chemotherapy

Endocrine therapy

• No concurrent hormonal cancer therapy

Radiotherapy

• No prior radiotherapy
• No concurrent radiotherapy

Surgery

• No concurrent anticancer surgery

Other

• More than 30 days since prior investigational drugs
• No prior enrollment on this study
• No other concurrent experimental medications (except thymidine)
• No other concurrent anticancer therapy