Lung cancer locally advanced disease

The first step in treatment of NSCLC involves confirmation of the clinical stage and determination of resectability of the tumor. This decision always should be made by a thoracic surgeon who routinely performs lung cancer surgery. Treatment options depend on the advancement of disease (i.e., local, locally advanced, or metastatic). 

Pemetrexed is a folic-acid antagonist that disrupts folate-dependent metabolic processes essential for cell replication. It is indicated in combination with cisplatin for the treatment of malignant pleural mesothelioma in patients whose disease is unresectable or who are otherwise not candidates for curative surgery and as a single agent for the treatment of locally advanced or metastatic non-small-cell lung cancer after prior chemotherapy. 

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