Inclusion Criteria:

1. Patients with histologically or cytologically confirmed locally advanced (stage
IIIB) or metastatic (stage IV) NSCLC

2. No previous adjuvant or palliative chemotherapy

3. No previous radiotherapy

4. Presence of at least one unidimensionally measurable lesion (Appendix 2)

5. ECOG performance status of 0 or 1 (Appendix 3)

6. Charlson score ≤ 2 (Appendix 4)

7. Adequate bone marrow function (absolute neutrophil count ≥ 2 x 109/L, platelet count
≥ 100 x 109/L, and hemoglobin level ≥ 100 g/L), and adequate liver function
(bilirubin level < two times the upper limit of normal, AST and/or ALT < three times
the upper limit of normal, prothrombin time < 1.5 times control), and creatinine
clearance ≥ 60 ml/min.

8. Absence of symptomatic CNS metastases (patients with cerebral metastases treated with
brain irradiation may be included), severe cardiac arrhythmia or heart failure,
second or third degree heart block or acute myocardial infarction within 4 months
prior to study entry.

9. No major surgery or pleurodesis within 14 days prior to enrollment.

10. Life expectancy of at least 12 weeks.

11. No previous or concurrent malignancy, except inactive non-melanoma skin cancer, in
situ carcinoma of the cervix, or other cancer if the patient has been disease-free
for more than 5 years.

12. Written informed consent

Exclusion Criteria:

1. Any unstable systemic disease (including active infection, uncontrolled hypertension,
unstable angina, congestive heart failure, serious cardiac arrhythmia requiring
medication, hepatic, renal or metabolic disease).

2. Patients with clinically significant effusions.

3. Any other malignancies within 5 years that could affect therapy evaluation