In combination w/ cisplatin: Treatment of chemotherapy naive patients w/ unresectable malignant pleural mesothelioma & 1st-line treatment in locally advanced or metastatic non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology. Monotherapy: Maintenance of locally advanced or metastatic NSCLC other than predominantly squamous platinum-based chemotherapy & 2nd-line treatment in patients w/ locally advanced or metastatic NSCLC other than predominantly squamous cell histology.
Combination w/ cisplatin 500 mg/m2 IV infusion over 10 min on day 1 of each 21-day cycle + cisplatin 75 mg/m2 infused over 2 hr approx 30 min thereafter. NSCLC 500 mg/m2 IV infusion over 10 min on day 1 of each 21-day cycle. Premed regimen Corticosteroid equiv to 4 mg oral dexamethasone bid. Administer corticosteroid given the day prior to, on the day of, & the day after pemetrexed administration. Vit supplementation: Oral folic acid or multivit containing folic acid (35-1,000 μg) daily. Vit B12 (1,000 μg) in the wk preceding the 1st dose of pemetrexed & once every 3 cycles thereafter. Subsequent doses may be given in the day as pemetrexed.
Suppressed bone marrow function. Not recommended to patients w/ CrCl <45 mL/min. Skin reactions, serious renal (including acute renal failure) & CV events (MI, cerebrovascular), severe dehydration due to GI toxicity. Immunodepressed patients. Concomitant use w/ NSAIDs & ASA; live attenuated vaccines. Effective contraception (for women of childbearing potential) or abstinence are recommended. Administer folic acid & vit B12. Males should not father a child during & up to 6 mth or require sperm storage. Monitor for myelosuppression; CBC, WBC & platelet count. Patients treated w/ radiation prior, during or subsequent to therapy. May impair ability to drive or operate machinery. Pregnancy & lactation.
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