A randomized placebo-controlled phase II/III with celecoxib in patients with locally advanced or metastatic non-small cell lung cancer.

1. Histological or cytological diagnosis of unresectable (stage III-b with or without pleuritis carcinomatosa) or disseminated (stage IV) NSCLC;

2. Age ≥ 18 years;

3. No prior chemotherapeutic treatment for NSCLC;

4. Measurable tumour on physical examination, chest X-ray, CT-scan;

5. Performance status 0-2 (WHO-score, see appendix II);

6. Prior radiotherapy is allowed as long as: No more than 25% of red bone marrow was irradiated;

7. The irradiated area is not the only source of measurable disease;

8. Estimated life expectancy of at least 12 weeks;

9. Adequate bone marrow reserve: leukocytes ≥ 3,0 x109/L, neutrophils ≥ 1,5 x109/L, platelets 100 .≥ x109/L, and hemoglobin ≥ 6,2 mmol/L;

10. Adequate renal function (serum creatinine ≤ 130 ¦Ìmol/L or creatinine clearance ≥ 60 ml/min);

11. Adequate liver function (total bilirubin ≤ UNL, ALAT/SGPT and ASAT/SGOT ≤ 2,0 x UNL, alkaline phosphatase ≤ 5,0 x UNL for the institution (UNL = Upper Normal Limit);

12. Patients of childbearing age should take medically approved contraceptive precautions during the trial and 3 months afterwards;

13. The subject is willing to abstain from chronic use of all NSAIDs or COX-2 inhibitors. Chronic use of NSAIDs is defined as a frequency of 7 consecutive days (1 week) for >3 weeks per year or more than 21 days throughout the year;

14. The use of cardioprotective dosages acetyl salicylic acid < 150 mg/day is allowed;

15. Patients must be able to comply with the scheduled visits;

16. Patients must give written informed consent before starting the study.

1. Other serious diseases, such as congestive heart failure NYHA class II-IV, established ischaemic heart disease or cerebrovascular disease, myocardial infarction within the last 12 months, peripheral arterial disease, uncontrolled hypertension, active peptic ulcer, active gastrointestinal bleeding, active infection or significant psychiatric illness;

2. Symptomatic brain metastases;

3. Patients with uncorrected hypercalcemia;

4. Patients with peripheral polyneuropathy grade ≥ 2 CTC Criteria;

5. Patients with a second primary malignancy except carcinoma in situ of the cervix or adequately treated basal cell carcinomas of the skin or adequately treated upper respiratory tract malignancies, disease-free more than 1 year after treatment;

6. ASAT and ALAT > 1,5 x UNL and alkaline phosphatase > 2,5 x UNL;

7. Patients who are pregnant or breast-feeding;

8. Known hypersensitivity or intolerance for NSAIDs, acetyl salicylic acid or olphonamides;

9. Participation in another trial with an investigational drug.