NICE has published guidance (TA 181) recommending pemetrexed in combination with cisplatin as an option for the first-line treatment of patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) only if the histology of the tumour has been confirmed as adenocarcinoma or large-cell carcinoma.

 
People who are currently being treated with pemetrexed for NSCLC but who do not meet these criteria should have the option to continue their therapy until they and their clinicians consider it appropriate to stop.

The cost of pemetrexed treatment per patient, assuming an average of four treatment cycles, is approximately £6400. Costs may vary in different settings because of negotiated procurement discounts.