OBJECTIVES:

• Determine the efficacy of cisplatin, etoposide, and thoracic radiotherapy followed by cisplatin, etoposide, monoclonal antibody 11D10 anti-idiotype vaccine (TriAb), and monoclonal antibody GD2 anti-idiotype vaccine (TriGem), in terms of overall and progression-free survival of patients with limited stage small cell lung cancer.
• Determine the immune response to each of the 2 anti-idiotype vaccines when used in this regimen in these patients.
• Determine the qualitative and quantitative toxicity of this regimen in these patients.
• Determine the response rates (confirmed and unconfirmed, complete and partial) in patients with measurable disease treated with this regimen.

OUTLINE: This is a multicenter study.

• Induction therapy: Patients receive cisplatin IV over 1 hour on days 1, 8, 29, and 36 and etoposide IV over 1 hour on days 1-5 and 29-33. Thoracic radiotherapy is administered 5 days a week, beginning on day 1 of chemotherapy, for 5 weeks. Patients then undergo radiotherapy boost for 1.5 weeks.

Patients with stable disease or at least partial response proceed to consolidation therapy.

• Consolidation therapy (begins within 3-5 weeks of the last dose of induction chemotherapy or radiotherapy): Patients receive cisplatin IV over 1 hour on day 1 and etoposide IV over 1 hour on days 1-3 of weeks 11 and 14. Patients also receive monoclonal antibody 11D10 anti-idiotype vaccine (TriAb) and monoclonal antibody GD2 anti-idiotype vaccine (TriGem) intradermally on day 1 of weeks 11, 13, 15, and 17 (4 injections) and then monthly subcutaneously for 2 years. Treatment continues in the absence of disease progression or unacceptable toxicity.

Patients who achieve complete response after consolidation chemotherapy undergo cranial radiotherapy 5 days a week for 3 weeks.

Patients are followed every 3 months for 2 years and then every 6 months for 3 years.

PROJECTED ACCRUAL: A total of 90 patients will be accrued for this study within 18 months.

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed limited stage small cell lung cancer (SCLC)
• Evidence of disease by CT scan of the chest
• Measurable or evaluable disease outside of area of prior surgical resection
• No malignant pericardial or pleural effusions (cytologically positive effusions or exudative effusions not attributable to other etiologies)
• No CNS disease by chest CT scan or MRI

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Zubrod 0-1

Life expectancy

• Not specified

Hematopoietic

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

Hepatic

• Not specified

Renal

• Creatinine no greater than upper limit of normal OR
• Creatinine clearance at least 60 mL/min

Other

• No prior hypersensitivity or contraindication to monoclonal antibody 11D10 anti-idiotype vaccine (TriAb), monoclonal antibody GD2 anti-idiotype vaccine (TriGem), or aluminum hydroxide
• No known sensitivity to rodent proteins (i.e., anti-OKT-3, ONCOSCINT scan)
• No grade 1 or greater symptomatic sensory neuropathy
• No other malignancy except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, adequately treated stage I or II cancer in complete remission, or any other cancer for which patient has been disease free for 5 years
• If significant clinical hearing loss already present, must accept risk of further hearing loss
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No prior biologic therapy for SCLC
• No prior TriAb or TriGem
• No prior murine antibodies
• No prior mouse proteins
• At least 30 days since prior immunotherapy
• At least 30 days since any prior immunization

Chemotherapy

• No prior systemic chemotherapy for SCLC
• No concurrent cyclophosphamide or methotrexate

Endocrine therapy

• At least 30 days since prior systemic corticosteroids
• No concurrent systemic corticosteroids (except as an antiemetic)

Radiotherapy

• No prior radiotherapy to the thorax or neck region
• No concurrent intensity modulated radiotherapy

Surgery

• See Disease Characteristics
• At least 2 weeks since prior thoracic or other major surgery and recovered

Other

• At least 30 days since prior investigational agents or devices
• No other concurrent investigational agents
• No other concurrent immunosuppressants (e.g., cyclosporine)
• No concurrent chronic systemic antihistamines
• No concurrent amifostine