RESEARCH ARTICLE The pemetrexed-containin

Lung cancer is the most-common cause of cancer-related mortality worldwide and non-small cell Lung cancer (NSCLC) accounts for more than 85 % of primary lung cancers and approximately two-thirds of NSCLC patients are diagnosed at an advanced stage [1-3]. Platinum-based chemotherapy is appropriate for selected patients who have a good performance status [4,5]. But the approach of treating patients with a platinum-containing regimen may have reached a plateau in terms of efficacy [6]. Most patients receiving front-line chemotherapy may experience disease progression and need second-line therapy [7]. One of several treatments for NSCLC as the second line therapy is pemetrexed, which is increasing its therapeutic scope from second-line therapy to first-line and maintenance therapy [8-10]. Pemetrexed is a multitargeted antifolate agent, inhi-biting at least three of the enzymes involved in DNA synthesis and folate metabolism: thymidylate synthas