Pemetrexed Injection is a folate analog metabolic inhibitor indicated...in combination with cisplatin for the initial treatment of patients with locally advanced or metastatic, non-squamous, NSCLC...

Pemetrexed medac in combination with cisplatin is indicated for the first line treatment of patients with locally advanced or metastatic non-small cell lung cancer other than predominantly squamous cell histology.

Recommendation 5.2. Concurrent chemotherapy delivered with radiation therapy for definitive treatment of stage III NSCLC should include a platinum-based doublet, preferably cisplatin plus etoposide, carboplatin plus paclitaxel, cisplatin plus pemetrexed (non-squamous only), or cisplatin plus vinorelbine (Type: Evidence based; benefit outweighs harm; Evidence quality: high; Strength of recommendation: strong)....Qualifying Statement: Carboplatin may be substituted for cisplatin in patients with contraindications to or deemed ineligible for cisplatin.

For patients with metastatic nonsquamous NSCLC and PS 0 and 1 who have contradictions to immunotherapy, the panel decided that the following chemotherapy regimens are "useful in certain circumstances" including 1) carboplatin with paclitaxel (or albumin-bound paclitaxel), docetaxel, etoposide, gemcitabine, or pemetrexed; all are category 1; 2) cisplatin with paclitaxel (or albumin-bound paclitaxel), docetaxel, etoposide, gemcitabine, or pemetrexed; all are category 1; 3) bevacizumab with carboplatin and either paclitaxel or pemetrexed; and 4) gemcitabine with either docetaxel or vinorelbine.