Neoadjuvant Chemoradiotherapy With or Without Gefitinib in Treating Patients With Stage IIIA or Stage IIIB Non-Small Cell Lung Cancer

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed non-small cell lung cancer

  • Stage IIIA (T1-3, N2)

    • Positive (pathological) ipsilateral mediastinal node

  • Selective stage IIIB meeting all of the following criteria:

    • No pleural/pericardial effusion or superior vena cava syndrome
    • T4 due to invasion of carina, trachea, or mediastinal structures
    • Mediastinal N3 nodes (without supraclavicular or cervical adenopathy)
• Proof of N2 or N3 status requires surgical staging of the mediastinum (mediastinoscopy, mediastinotomy, or exploration)
• Expression of epidermal growth factor receptor (at least 1+) by immunohistochemistry
• Measurable disease by contrast CT scan allowed
• No bronchoalveolar cell carcinoma
• No prior diagnosis of lung cancer

PATIENT CHARACTERISTICS:

Age

• 19 and over

Performance status

• ECOG 0-1 (0-2 if albumin is at least 0.85 times lower limit of normal and weight loss within 3 months before diagnosis is no greater than 10%)

Life expectancy

• Not specified

Hematopoietic

• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 150,000/mm^3
• Hemoglobin at least 10 g/dL

Hepatic

• Bilirubin normal
• AST and ALT no greater than 2.5 times upper limit of normal (ULN)

• Alkaline phosphatase no greater than 2 times ULN

  • Alkaline phosphatase between 1.5-2 times ULN requires a negative bone scan for metastatic bone disease

Renal

• Creatinine no greater than 1.4 mg/dL OR
• Creatinine clearance at least 60 mL/min

Cardiac

• No myocardial infarction within the past 3 months
• No active angina
• No unstable heart rhythms
• No congestive heart failure

Pulmonary

• Post-resection predicted FEV_1% greater than 35%

  • Predicted FEV_1% is defined as FEV_1% times percent perfusion to uninvolved lung from quantitative lung V/Q scan report

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for at least 6 weeks after study treatment
• No other uncontrolled medical illness
• No other malignancy within the past 5 years except basal cell skin cancer or carcinoma in situ of the cervix
• No grade 2 or greater peripheral neuropathy
• No concurrent ocular inflammation or infection
• No prior severe hypersensitivity reaction to docetaxel or other drugs formulated with polysorbate 80
• No known severe hypersensitivity reaction to gefitinib or any of its excipients
• No prior severe allergic reaction to platinum-containing compounds or mannitol

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No concurrent growth factors (e.g., filgrastim [G-CSF] or sargramostim [GM-CSF]) during chemotherapy

Chemotherapy

• No prior chemotherapy for lung cancer

Endocrine therapy

• Not specified

Radiotherapy

• No prior radiotherapy for lung cancer

Surgery

• Recovered from prior major surgery
• No concurrent ophthalmic surgery

Other

• More than 30 days since prior unapproved or investigational drugs

• No concurrent use of the following drugs:

  • Phenytoin
  • Carbamazepine
  • Barbiturates
  • Rifampin
  • Phenobarbital
  • Hypericum perforatum (St. John's Wort)
  • Warfarin
• No concurrent retinoids