• Objective response [ Designated as safety issue: No ]
  

• Duration of response [ Designated as safety issue: No ]
  
• Survival [ Designated as safety issue: No ]
  

OBJECTIVES:

• Determine the frequency and duration of response in patients with recurrent small cell lung cancer treated with interferon alfa, isotretinoin, and paclitaxel.
• Determine the toxic effects of this regimen in these patients.
• Determine the duration of survival in patients treated with this regimen.
• Correlate the levels of bcl-2 in peripheral blood monocytes with response and survival in patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients receive interferon alfa subcutaneously and oral isotretinoin on days 1 and 2 and paclitaxel IV over 1 hour on day 2 of weeks 1-6. Courses repeat every 8 weeks in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 2 years and then every 6 months for 1 year.

PROJECTED ACCRUAL: A total of 37-83 patients will be accrued for this study.

DISEASE CHARACTERISTICS:

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

  • Recurrent disease
• Prior chemotherapy for SCLC required
• Clinically confirmed measurable disease

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• ECOG 0-3

Life expectancy

• Not specified

Hematopoietic

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

Hepatic

• Bilirubin no greater than 1.5 mg/dL
• AST no greater than 2 times upper limit of normal (ULN)

Renal

• Creatinine no greater than 1.5 mg/dL

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception for 1 month before, during, and for 1 month after study treatment
• Triglycerides no greater than 1.5 times ULN
• No other prior malignancy except nonmetastatic, nonmelanoma skin cancer, carcinoma in situ of the cervix, or cancer cured by surgery or small field radiotherapy more than 5 years prior to study entry
• No severe (≥ grade 2) depression requiring medication

PRIOR CONCURRENT THERAPY:

Biologic therapy

• More than 4 weeks since prior filgrastim (G-CSF) or sargramostim (GM-CSF)
• No prior interferon alfa
• No concurrent G-CSF or GM-CSF
• Concurrent epoetin alfa allowed

Chemotherapy

• See Disease Characteristics
• More than 60 days since prior chemotherapy
• No prior paclitaxel

Endocrine therapy

• Not specified

Radiotherapy

• More than 60 days since prior radiotherapy

Surgery

• Not specified

Other

• Recovered from prior therapy

• More than 4 weeks since prior administration of any of the following drugs:

  • Ethanol
  • Tetracycline
  • Doxycycline
  • Minocycline
  • Topical acne products (e.g., tretinoin-containing products)
  • Vitamin A
  • Carbamazepine
  • Ketoconazole
  • Phenytoin or other antiepileptic drugs
• No concurrent vitamin supplements containing vitamin A during isotretinoin administration