Inclusion Criteria:

- Suspected or biopsy-proven NSCLC

- Willingness to provide biopsy tissue for correlative studies

- Candidate for pulmonary resection; must be able to schedule >= 14 days and =< 42 days
between registration and surgery to allow for treatment with pioglitazone

- Ability to understand and the willingness to sign a written informed consent document

- Ability and willingness to swallow oral tablets

- Ability and willingness to undergo two bronchoscopies (before treatment and at the
time of surgery)

- For those participants who are undergoing mediastinoscopy as part of their
standard-of-care, the pre-treatment bronchoscopy may be performed during the
mediastinoscopy; if the participant remains eligible for definitive surgical
resection after the mediastinoscopy, the participant may proceed to registration
and pioglitazone treatment

- Current or former smoker with a >= 10 pack-year smoking history

- Women of child-bearing potential and men who agree to use adequate contraception for
the duration of study participation; the effects of pioglitazone on the developing
human fetus at the recommended therapeutic dose are unknown; for this reason, women
must not be pregnant or lactating. Women of child-bearing potential (women considered
not of childbearing potential if they are at least two years postmenopausal and/or
surgically sterile) must have used adequate contraception (abstinence; barrier
methods such as IUD, diaphragm with spermicidal gel, condom, or others; and hormonal
methods such as birth control pills or others) since her last menses prior to study
entry; should a woman become pregnant or suspect she is pregnant while participating
in this study, she should inform her study physician immediately

Exclusion Criteria:

- Receiving any other investigational agents

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to pioglitazone

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements

- Pregnant or lactating woman

- Currently treated diabetes

- Participants with >= class II NYHA congestive heart failure or history of congestive
heart failure

- Participants with >= grade 2 (moderate) edema

- Participants currently receiving an inhibitor of CYP2C8 (gemfibrozil, ketoconazole,
quercetin, trimethoprim), or an inducer of CYP2C8 (cortisol, dexamethasone,
phenobarbital, rifampin), or CYP3A4 substrate

- Prior neoadjuvant therapy for NSCLC

- History of bladder cancer or in situ bladder cancer