Paclitaxel and Carboplatin With or Without Nitroglycerin in Treating Patients With Previously Untreated Stage III or Stage IV Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed non-small cell lung cancer
• Stage IIIB or IV disease that cannot be treated by radical irradiation
• Tumor lesions must be objectively evaluated according to WHO criteria (maximum diameter is no shorter than twice the slice width and no shorter than 10 mm) by CT scan
• No brain metastasis

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• Life expectancy ≥ 3 months
• Neutrophil count > 2,000/μL
• Hemoglobin > 10.0 g/dL
• Platelet count > 100,000/μL
• Serum bilirubin < 2.0 mg/dL
• ALT and AST < 100 IU/L
• Serum creatinine < 2.0 mg/dL
• PaO_2 ≥ 70 mm Hg
• No cardiac problems, including any of the following:
• Poorly controlled hypertension
• Unstable angina
• Congestive heart failure
• Myocardial infarction within the past year
• Ventricular arrhythmia that requires treatment except single, well-controlled isolated ventricular extrasystole
• No chronic active hepatitis or cirrhosis requiring treatment except hepatitis virus carriers who do not need treatment
• No comorbidity of interstitial pneumonia and pulmonary fibrosis requiring treatment
• No other cancer requiring treatment except a malignant tumor curatively resected with no recurrence
• No severe psychiatric disorders including schizophrenia or dementia
• Cardiothoracic ratio < 60% by chest x-ray
• No history of severe drug allergy or allergy to polyoxyethylene castor oil (in some anesthetic drugs or muscle relaxants) or polysorbate 80
• Patients in whom nitroglycerin preparations are contraindicated are not eligible, including any of the following:
• Severe hypotension (e.g., systolic blood pressure ≤ 80 mm Hg)
• Angle-closure glaucoma
• History of hypersensitivity to nitrate/nitrite ester drugs
• Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy or radiotherapy
• Pleurodesis is not considered chemotherapy
• At least 1 week since prior and no other concurrent nitric oxide donors (e.g., nitroglycerin)
• At least 1 week since prior and no concurrent calcium antagonists
• At least 1 week since prior and no concurrent drugs for erectile dysfunction that inhibit phosphodiesterase 5 (e.g., sildenafil citrate or vardenafil hydrochloride hydrate)
• More than 24 hours since prior and no concurrent administration of the following:
• Antifungal azoles, including ketoconazole, miconazole, or itraconazole
• Macrolides, including erythromycin or clarithromycin
• Cyclosporines
• Benzodiazepines, including diazepam, triazolam, or midazolam
• Vitamin A
• Steroid hormones, including ethinylestradiol
• No concurrent participation in another clinical trial