The purpose of the study is to document the activity and safety of single agent amrubicin, amrubicin combined with cisplatin, and etoposide combined with cisplatin as first-line treatment in extensive disease small cell lung cancer.

Inclusion Criteria:

• Histologically/cytologically proven small cell lung cancer
• Extensive disease
• Measurable disease
• World Health Organization (WHO) performance status 0-2
• Age 18 years or older
• Normal baseline cardiac function
• No prior systemic chemotherapy for small cell lung cancer
• Adequate organ function including bone marrow, kidney, and liver
• No history of interstitial lung disease or pulmonary fibrosis
• No history of prior malignancy unless patient has been disease free for greater than 5 years, or the tumour was a non-melanoma skin cancer or in-situ carcinoma of the cervix
• No pregnancy or breast feeding; patients of child-bearing potential must agree to use an appropriate method of contraception
• Written informed consent before randomization

Exclusion criteria:

• Pre-existing peripheral neuropathy (greater than Grade 1, CTCAE version 3.0)
• Uncontrolled or severe cardiovascular disease
• Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule