Objective. We evaluated the feasibility of pemetrexed (PEM) treatment for third-line or higher chemotherapy for non-squamous, non-small cell lung cancer (NSCLC) patients. Methods. We retrospectively analyzed 25 consecutive patients with advanced non-squamous NSCLC who were treated with PEM as third-line or higher chemotherapy between May 2009 and March 2010. Results. Patients composed 15 men and 10 women, with a median age of 67 years (range 51-78 years). The histological subtype was adenocarcinoma in 24 patients and large cell carcinoma in 1 patient. A total of 5 patients had stage IIIB and 20 patients had stage IV disease. The number of prior regimens was 2 in 12 patients, 3 in 4 patients, and 4 or more in 9 patients. The median number of PEM courses was 7. The number of courses was 1 in 3 patients, 24 in 7 patients, 5-9 in 7 patients, and 10 or more in 8 patients. Hematological toxicities of grade 3 or more included leukocytopenia in 3 patients (12.0%), neutrocytopenia in 4 patients (16.0%) and anemia in 1 patient (4.0%). Grade 3 non-hematological toxicity included a rash in 2 patients (8.0%), but no other serious adverse events were observed. A partial response (PR) was observed in 1 patient stable disease (SD) in 18 patients and progressive disease (PD) in 6 patients. The median progression-free survival was 22.0 weeks, and overall survival was 47.8 weeks. Conclusion. PEM treatment might be feasible for third-line or higher chemotherapy for NSCLC patients.
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