Inclusion Criteria:

- Histologically or cytologically proven non-small cell lung carcinoma

- Stage IV metastatic non-small cell lung carcinoma or stage III with malignant pleural
effusion.

- Patient should not be eligible for customization chemotherapy (if available at
participating institutions).

- Having at least one measurable lesion

- Patient has life expectancy of 12 weeks or greater.

- Age > 18 years.

- No prior systemic treatment for metastatic lung cancer. Adjuvant treatment given
more than 1 year ago is acceptable.

- WHO performance status 0-2 (See Appendix III )

- Adequate organ function:

- Hematology: Neutrophils > 2 x 10 9 /L, platelets > 100 x 10 9 /L

- Hepatic function: Total bilirubin < 1.25 times the upper normal limits, ASAT
(SGOT) < 2 times the upper normal limits

- Renal function: Creatinine < 1.5 mg/dL; if value is higher than upper normal
limit but less than 2 mg/dL, the creatinine clearance should be > 60min/ml.

- Able to comply with scheduled follow-up and with management of toxicity

- Signed informed consent from patient or legal representative

- Negative urine pregnancy test (if indicated)

Exclusion Criteria:

- Pregnant or lactating women or women of childbearing potential using inadequate
contraception.

- Uncontrolled brain metastatic disease. (CNS disease that is stable > 4 weeks after
radiotherapy in lieu of steroids reduction is eligible).

- Symptomatic peripheral neuropathy > grade 1 according to the NCI Common Toxicity
Criteria Version 3

- Other serious illness or medical condition:

- Unstable cardiac disease requiring treatment

- History of significant neurologic or psychiatric disorders including psychotic
disorders, dementia or seizures

- Active uncontrolled infection

- Concurrent treatment with other experimental drugs. Participation in another
clinical trial with any investigational drug within 30 days prior to study screening

- Concurrent treatment with any other anti-cancer therapy

- Contraindication of steroid drug administration

- Past (up to 5 years) or concurrent history of other neoplasm except curatively
treated non- melanoma skin cancer or in situ carcinoma of the cervix