Background and purpose: The effective rate of first-line chemotherapy for advanced lung cancer is 30%-40%. The purpose of this study was to evaluate the efficacy and adverse effects of pemetrexed combined with carboplatin or cisplatin in the treatment of patients with advanced non-squamous non-small cell lung cancer (NSCLC). Methods: One hundrend and twenty-one patients with advanced non-squamous NSCLC were enrolled in this study and all of these patients had been confirmed with pathology or cytology. Among the 121 cases

60 cases were male and 61 were female

the median age was 59 years

adnenocarcinoma in 113 patients and large cell carcinoma in 8 patients. Combination regimen: patients received pemetrexed 500 mg/m2 on day 1 and carboplatin 300 mg/m2 or cisplatin 70 mg/m2 on day 1 by intravenous infusion

administrated every 3 weeks for 2 to 6 cycles. All patients who received 2 or more cycles could be evaluated. Disease control rate (DCR) was the primary end point; secondary end points included progression-free survival (PFS)

1-year survival rate and safety. Results: There was 1 case with complete response (CR)

44 cases achieved partial response (PR)

50 had stable disease (SD) and 26 cases had progressive disease (PD) in the overall cases. ORR and DCR were 37.2% (45/121) and 78.5% (95/121)

respectively. The median PFS time was 5.2 months and 1-year survival rate was 59.0%. In pemetrexed combined with carboplatin group

the ORR and DCR were 38.3% (23/60) and 78.3% (47/60)

respectively; The median PFS was 5.1 months (95%CI: 3.8-6.4 month) and 1-year survival rate was 55.2%. The patients treated with pemetrexed plus cisplatin

the ORR and DCR were 36.1% (22/61) and 78.7% (48/61)

respectively. Median PFS was 6.2 months (95%CI: 4.3-8.1 month) and 1-year survival rate was 62.5%. There were no statistical differences between carboplatin/pemetrexed and cisplatin/pemetrexed for both ORR

DCR

PFS and 1-year survival rate (P0.05). The major adverse effects were leukopenia

neutropenia

fatigue and gastrointestinal reaction. Conclusion: Pemetrexed plus platinum chemotherapy could be considered as the firstline treatment option for advanced non-squamous NSCLC patients. Pemetrexed combined with carboplatin/ cisplatin regimen has efficacy with mild toxicity and better tolerability.