Introduction: Pemetrexed is widely used in treatment of patients with NSCLC but experience with use of pemetrexed in elderly patients (≥ 70 years of age) comes mainly from retrospective analysis.

Aim: To evaluate our institutional experience with pemetrexed in ≥ 70  yrs compared to ≤ 70  yrs patients.

 We looked at tumour characteristics, sex distribution, median number of cycles received and PFS trends in ≥ 70 yrs compared to ≤ 70 yrs. We also looked at whether chemotherapy was given as part of 2^nd line or maintenance therapy.

Methods:.

Inclusion criteria – Patients receiving pemetrexed for advanced NSCLC between January 2009 and December 2012.

Exclusion criteria - Patients who received pemetrexed for other malignancies.

Results: 11 patients were ≥ 70 yrs, of which 2 were females and 9 were males. 40 patients were ≤ 70 yrs of age, of which 23 were males and 17 were females. In both groups majority of tumors were adenocarcinomas with 9 patients ≥ 70 yrs and 32 patients ≤ 70 yrs. 1 patient had large cell tumor in ≥ 70 yrs group compared to 7 in ≤ 70 yrs group. 1 patient in each group had squamous cell histology.

In ≥ 70 yrs group 4 patients received pemetrexed as 2^nd line, 6 patients received as maintenance treatment. In ≤ 70 yrs group, 22 patients received 2^nd line pemetrexed, 17 patients as maintenance. Median number of cycles received by ≥ 70 yrs group was 7.18 compared to 7.5 in ≤ 70 yrs group. Median PFS was 5.03 months in ≥ 70 yrs group and 6.04 months in ≤ 70 yrs group.

Conclusion:

1. 1.01 month difference in median PFS between the groups.

2. Younger patients are more likely to receive pemetrexed as second line or as maintenance therapy than older patients.

3. No significant difference in median number of cycles received between the groups.