PR104 in Treating Patients With Previously Untreated or Relapsed Small Cell Lung Cancer

OBJECTIVES: Primary * Estimate the response rate of PR-104 in patients with treatment-naive or sensitive-relapse small cell lung cancer. * Evaluate safety of this drug in these patients. Secondary * Evaluate survival of these patients. * Evaluate progression-free survival of these patients. * Evaluate time to progression in these patients. * Assess the pharmacokinetics (PK) of PR-104 and its alcohol metabolite. * Estimate the rate of hypoxia using 18F-fluoromisonidazole (FMISO) positron emission topography (PET) imaging. * Collect plasma samples for assessment of potential biomarkers of tumor hypoxia. OUTLINE: This is a multicenter study. Patients are stratified according to disease type (treatment-naive vs sensitive-relapse). Patients receive PR-104 intravenously (IV) over 1 hour on day 1. Treatment repeats every 21 days for up to 4 courses (for treatment-naive patients) or in the absence of disease progression or unacceptable toxicity (for sensitive-relapse patients). PK studies are performed during course 1 and after course 3. Blood is collected at baseline, during course 1, and at study completion for biomarker studies of tumor hypoxia (plasma proteins). Patients also undergo FMISO PET and fludeoxyglucose F18 (FDG) PET scans at baseline and after the second course of study therapy.