Paclitaxel in Treating Patients With Lung Cancer

OBJECTIVES:

• Assess the therapeutic activity of paclitaxel in patients with bronchoalveolar carcinoma (BAC).
• Assess the duration of response in patients presenting with an objective response.
• Characterize the acute side effects of paclitaxel in patients with BAC.
• Assess the role of some biological parameters in the natural history and the response to therapy of BAC; evaluate the expression of Ki67, p53, and K-ras mutation.

OUTLINE: This is an open label, nonrandomized, multicenter study.

Paclitaxel is administered every 3 weeks as a 3 hour continuous infusion in dextrose or normal saline. Patients are treated for a minimum of 2 cycles unless serious toxicity or complication occur.

Disease is assessed every 6 weeks until documented progression; treatment side effects are assessed separately for each cycle of therapy. Treatment is given up to a maximum of 6 cycles of therapy or until disease progression, unacceptable toxicity, or patient refusal occurs.

PROJECTED ACCRUAL: 16 or 25 patients will be accrued.

DISEASE CHARACTERISTICS:

• Histologically proven bronchoalveolar carcinoma (BAC) based on these criteria:

• Absence of primary adenocarcinoma elsewhere
• Absence of a demonstrable central bronchogenic origin
• A peripheral location in the lung parenchyma
• Intact interstitial framework of the lung
• A histological appearance setting it apart from other tumors, with a characteristic pattern of growth: cuboidal or cylindrical cells lining up the alveolar septa with preservation of basic pulmonary architecture
• Must be unresectable Stage IIIB, IV, or recurrent BAC
• Evidence of multinodular lesions involving the lungs bilaterally or unilaterally (in the latter the lesions must involve more than one lobe)
• At least one target lesion bidimensionally measurable that has not undergone prior irradiation
• No CNS disease

PATIENT CHARACTERISTICS:

Age:

• 18 to 75 (inclusive)

Performance status:

• ECOG 0-2

Life expectancy:

• Greater than 3 months

Hematopoietic:

• ANC at least 1,500/mm^3

Hepatic:

• Bilirubin less than 2 times upper limit of normal
• SGOT, SGPT, and alkaline phosphatase less than 2 times upper limit of normal

Renal:

• Creatinine less than 1.5 times upper limit of normal

Cardiovascular:

• No history of ischemic or congestive heart disease
• No arrhythmia requiring chronic cardiopulmonary medications
• No history of clinically or electrographically documented myocardial infarction

Other:

• No preexisting motor or other serious sensory neurotoxicity
• No active or prior second primary cancer except basal cell carcinoma of the skin or carcinoma in situ of the cervix
• No clinical evidence of uncontrolled infection
• Not pregnant or nursing
• Negative pregnancy test 72 hours prior to start of study medication
• Adequate contraception required of all fertile patients

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• At least 4 weeks since radiotherapy
• Must have at least one bidimensional lesion outside the irradiated fields

Surgery:

• Fully recovered from any prior major surgery