The purpose of this study is to determine if the addition of motexafin gadolinium (study drug) to standard treatment with docetaxel will improve the response rate in patients with non-small cell lung cancer.

Preclinical and clinical data suggest that MGd has activity in NSCLC and that the combination of MGd and docetaxel may be more effective that docetaxel alone. In this trial, patients will receive 10 mg/kg MGd followed by 75 mg/m2 once every 3 weeks. This dosing regimen was well tolerated in the Phase I dose escalation trial. A Simon 2-stage trial design will be used; if at least 4 out of 39 evaluable patients in the first stage of the trial demonstrate objective clinical response, the study will proceed to Stage 2, where an additional 22 evaluable patients will be enrolled following the same treatment regimen and assessment schedule as in Stage 1. Patients with stable disease, CR, or PR will continue dosing up to 12 cycles and will be followed for response every 6 weeks until PD, death, or end of study.

Inclusion Criteria:

• ≥ 18 years old
• Histologically or cytologically confirmed diagnosis of NSCLC
• Inoperable Stage IIIA, unresectable Stage IIIB or metastatic NSCLC patients who have received 1 prior platinum-based chemotherapy regimen
• Measurable disease per RECIST
• ECOG performance status score of 0 or 1
• Willing and able to provide written informed consent

Exclusion Criteria:

• Laboratory values of: ANC < 1500/mm³, Platelet count < 100,000/mm³, hemoglobin < 10 g/dL, AST or ALT > 2.5 x upper limit of normal (ULN), Alkaline phosphatase > 5 x ULN, bilirubin > 1.5 x ULN, serum creatinine > 2.0 mg/dL (176 umol/dL), albumin < 3.0 g/dL (30 g/L)
• Symptomatic or uncontrolled (untreated or treated and progressing) brain metastases
• Evidence of meningeal metastasis
• > 1 prior cytotoxic regimen (not counting adjuvant or neo-adjuvant cytotoxic chemotherapy if completed > 12 months prior to cytotoxic regimen, or prior MGd)
• Chemotherapy, radiation therapy, experimental therapy, immunotherapy, or systemic biologic anticancer therapy within 21 days before beginning study treatment
• Significant weight loss ≥ 10% of body weight within preceding 6 weeks
• Treatment for another cancer within 3 years before enrollment, except basal cell carcinoma of the skin or cervical cancer in situ
• Myocardial infarction within 6 months of enrollment or congestive heart failure rated New York Heart Association Class III or IV
• Uncontrolled hypertension (systolic blood pressure > 160 mm Hg and diastolic blood pressure > 110 mm Hg on maximal medical therapy)
• Known history of porphyria (testing not required at screening visit)
• Known history of glucose-6-phosphate dehydrogenase (G6PD) deficiency (testing not required at screening visit)
• History of hypersensitivity to taxanes or polysorbate 80
• Known history of HIV infection (testing not required at screening visit)
• Female who is pregnant or lactating (serum pregnancy test is required for all female patients of childbearing potential)
• Sexually active male or female of childbearing potential unwilling to use adequate contraceptive protection
• Physical or mental condition that makes patient unable to complete specified follow-up assessments