⇚ Regimen ALIMTA® and PARAPLATIN® with KEYTRUDA® - for Non Small Cell Lung Cancer Medical Name ALIMTA® (Pemetrexed) followed by PARAPLATIN® (Carboplatin) and KEYTRUDA® (Pembrolizumab) for Non Small Cell Lung Cancer Cycles Given 4 Delivery Phases N/A Special Instructions Must be on Folic Acid and Vitamin B12 for at least one week prior to initiating treatment. Premedication with Dexamethasone 4 mg PO BID for three days starting one day prior to treatment. Administer PARAPLATIN® (Carboplatin) 30 minutes after ALIMTA® (Pemetrexed). Moderate to Highly emetogenic - ALOXI® (Palonosetron) and EMEND® (Aprepitant) recommended as premedications. Monitor closely for immune mediated end organ damage such as Pneumonitis, Colitis, Hepatitis, Endocrine disorders and Nephritis. Continue KEYTRUDA® until disease progression or unacceptable toxicity. Benefit with this regimen seen only in patients with non squamous histology. KEYTRUDA® and ALIMTA® maintenance starts after 4 cycles of this combination treatment References Langer CJ, et al. Lancet Oncol. 2016 - VIEW External References http://www.ncbi.nlm.nih.gov/pubmed/27745820 - VIEW Drug Mode Given Standard Dose Days to Be Given Frequency Solution Volume Duration ALIMTA® (Pemetrexed) IV 500 mg/m2 D1 q21 NSS 100 cc 15 minutes PARAPLATIN® (Carboplatin) IV AUC 5 D1 q21 NSS 250 cc 60 minutes KEYTRUDA® (Pembrolizumab) IV 200 mg D1 q21 NSS 250 cc 60 minutes