Following a second resubmission, the Scottish Medicines Consortium (SMC) has accepted pemetrexed (Alimta®) for restricted use within NHS Scotland in combination with cisplatin for the first line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) other than predominantly squamous cell histology.

The drug advice notes that treatment with pemetrexed plus cisplatin resulted in an improvement in median survival in patients with a non-squamous (adenocarcinoma plus large cell carcinoma) histology in a planned subgroup analysis of a study.  Its use is therefore restricted to patients in whom histology has been confirmed as adenocarcinoma or large cell carcinoma.