Pemetrexed: a review of its use in the management of advanced non-squamous non-small cell lung cancer.

Pemetrexed (Alimta) is a multi-targeted antifolate cytotoxic agent available for use in the treatment of adults with advanced non-squamous non-small cell lung cancer (NSCLC). It is indicated as initial therapy in combination with cisplatin, as monotherapy after prior chemotherapy, and as maintenance monotherapy in patients with locally advanced or metastatic non-squamous NSCLC. Pemetrexed has demonstrated efficacy and is generally well tolerated as a first-line therapy (in combination with cisplatin) and as second-line or maintenance monotherapy in advanced non-squamous NSCLC. While the survival benefits of comparator chemotherapies are retained with pemetrexed, pemetrexed has tolerability advantages that may also translate to pharmacoeconomic benefits, although this has yet to be shown in robust pharmacoeconomic analyses. Pemetrexed is an important option for the management of NSCLC, in particular as targeted therapy in patients with non-squamous histology.