Azacitidine in Treating Patients with Stage IV or Recurrent Non-small Cell Lung Cancer

Inclusion Criteria

• Pathologically proven (either histologic or cytologic) diagnosis of stage IV or recurrent non-small cell lung cancer (according to American Joint Committee on Cancer [AJCC] staging, 7th edition)
• Patient has received at least one prior standard chemotherapy or targeted therapy for treatment of lung cancer
• Eastern Cooperative Oncology Group (ECOG) performance status 0-1
• Absolute neutrophil count (ANC) >= 1,500 cells/ul
• Platelets >= 100,000 cells/ul
• Hemoglobin >= 9.0 g/dl (note: the use of transfusion or other intervention to achieve hemoglobin [Hgb] >= g/dl is acceptable)
• Serum creatinine =< 1.5 x upper limit of normal (ULN)
• Total bilirubin < 2.0 times the institutional upper limit of normal (ULN)
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x the ULN
• Adequate pulmonary reserve defined as adequate airflow defined by a measured forced expiratory volume (FEV1) not less than 50% of the predicted value and adequate pulmonary reserve as evidenced by a FEV1/forced vital capacity (FVC) ratio of 65% or greater
• Patient must sign study specific informed consent prior to study entry
• Women of childbearing potential must have: * A negative serum or urine pregnancy test (sensitivity =< 25 IU human chorionic gonadotropin [HCG]/L) within 72 hours prior to the start of study drug administration * Persons of reproductive potential must agree to use and utilize an adequate method of contraception throughout treatment and for at least 4 weeks after study drug is stopped prior to study enrollment, women of childbearing potential must be advised of the importance of avoiding pregnancy during trial participation and the potential risk factors for an unintentional pregnancy

Exclusion Criteria

• Concomitant disease or condition that could interfere with the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the patient in this study
• Contraindication to or unwillingness to undergo study related procedures including a repeat bronchoscopy
• Participation in an investigational drug or device study or treatment with any antineoplastic agent within 14 days of the first day of dosing on this study
• History of significant bleeding disorder unrelated to cancer, including: * Diagnosed congenital bleeding disorders (e.g., von Willebrand’s disease) * Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor VIII antibodies)
• History of hypersensitivity to mannitol
• Unwillingness or inability to comply with the study protocol for any other reason
• Women who: * Are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for at least 4 weeks after cessation of study drug, or * Have a positive pregnancy test at baseline, or * Are pregnant or breastfeeding
• Prisoners or subjects who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious) illness