• - Overall survival (OS)
  

• - Progression Free Survival (PFS)
  
• - Time to Progression (TTP)
  
• - Clinical Benefit assessed by Performance Status and body weight
  
• - Quality of Life using the LCSS and EuroQoL validated instruments
  
• - Toxicity and safety assessment using NCI CTC version 2.0
  

Inclusion Criteria:

• Pathological diagnosis: Histologically or cytologically proven SCLC.
• Disease stage: extensive stage
• Measurable disease by the RECIST criteria is required. Lesions that are present in previously irradiated area are non-measurable unless they have appeared or progressed since completion of the radiation.
• Radiotherapy, if applicable, must have been completed at least 4 weeks before treatment under this protocol and the subject must have recovered from any acute toxicities of radiation.
• Recovered from any surgical procedure(s).
• Calculated creatinine clearance > 55 ml/min using the Cockcroft-Gault formula: Cr Cl in ml/min = (140-age) X (weight in kg) X (1.0 for men or 0.85 for women) / (72 X serum Cr in mg/dl).
• Total bilirubin < two times the upper limit of the normal range at the institution and SGOT/AST < two times the upper limit of normal unless liver metastases are present.
• ANC > 1.5 x 109/L and platelet count > 100 x 109/L.
• Age >18 years.
• Karnofsky Performance Status > 70% .
• Subjects with no prior malignancy, or subjects with cured malignancies other than SCLC if: a) they are alive without disease recurrence for at least 5 years from the date of pathological diagnosis, and b) clinical expectation of disease recurrence is < 5% as documented in the medical record by the responsible physician, and c) they have not received any platinum-based therapy. Subjects with basal cell carcinoma or carcinoma in situ of the cervix may be eligible if adequately treated and clinical expectation of disease recurrence is < 5% as documented in the medical record by the responsible physician.
• Infertile subjects or fertile subjects who use a medically acceptable contraceptive throughout the treatment period and for 3 months following cessation of treatment. Women of childbearing potential must have documentation of a negative, serum HCG pregnancy test. Subjects must be made aware, before entering this trial, of the risk in becoming pregnant or in fathering children.
• Signed written informed consent (approved by the Ethics Committee) obtained prior to study entry.

Exclusion Criteria:

• Limited disease.
• Symptomatic brain metastases: a patient with brain and/or leptomeningeal metastases on computer tomography (CT) or Magnetic Resonance Imaging (MRI) scan may be included only if he/she is asymptomatic on neurologic exam and is not receiving corticosteroid therapy to control symptoms.
• Concurrent active cancer, including cancer stable on adjuvant therapy.
• Prior immunotherapy, biological therapy or chemotherapy for SCLC.
• Radiotherapy: Prior radiation to non-symptomatic or non-life-threatening sites.Prior radiation therapy to all potential indicator lesions. Prior radiation therapy to some but not all indicator lesions is allowed.
• Class III or IV congestive heart failure according to the New York Heart Association Classification.
• History of allergic reactions to appropriate diuretics or antiemetics (e.g., 5-HT3 antagonists) to be administered in conjunction with protocol-directed chemotherapy.
• Uncontrolled intercurrent illness.
• Lactating or pregnant women.
• Received any investigational drug within 30 days before beginning treatment with study drug.