Background Since pemetrexed was marketed for the treatment of non-squamous non-small cell lung cancer (NSCLC), several patients have been treated with the combination of platinum-pemetrexed instead of other cytotoxic regimens, which is much more expensive, although its efficacy is unknown.

Purpose To describe the treatment of patients diagnosed with non-squamous NSCLC over time and to explore the differences in efficacy.

Materials and methods Observational study of all the patients treated in a university hospital for metastatic non-squamous NSCLC during the period 1 July 2008 to 30 June 2010. Clinical and anthropometric data were collected from medical history records, treatment data were collected from pharmacy records. Efficacy was measured as overall survival, measured as the difference between the date of diagnosis and date of death.

Results 59 patients were treated during the study period for metastatic non-squamous NSCLC. The most frequent regimens were platinum-paclitaxel (22), platinum-pemetrexed (19) and platinum-vinorelbine (11). 7 patients received other different chemotherapy regimens. Anthropometric characteristics were similar between the two first groups (table 1). In the second six months of 2008 the most frequently-prescribed regimen was the combination of platinum-paclitaxel. During the first six months of 2009, the combination platinum-pemetrexed became the most frequently prescribed regimen, at the expense of the previous. During the second six months of 2009 and the first six months of 2010 these combinations were used approximately equally often. During these periods overall survival was similar, between 9.5 and 11.7 months, with a total of 10 censored data (Fig 1). Median overall survival times for each regimen were: platinum-paclitaxel 9 months, platinum-pemetrexed 10.1 months, platinum-vinorelbine 16.8 months, other regimens 9 months.

Conclusions Most patients with non-squamous NSCLC were treated over these 2.5 years with two different regimens: platinum-paclitaxel and platinum-pemetrexed, with similar results in overall survival. Studies should be performed to demonstrate if the quality of life is worth the price difference.