Nearly all survey respondents who would employ carboplatin/pemetrexed as induction therapy for an 80-year-old patient would go on to offer pemetrexed maintenance. Both faculty members endorse this strategy, and although Dr Ramalingam finds pemetrexed to be well tolerated in elderly patients, he individualizes the decision about maintenance and for how long to use it based on many factors, including the extent of the disease and related symptomatology, the severity of toxicities and the patient’s goals and expectations.

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Gerber DE et al. Maintenance chemotherapy for advanced non-small-cell lung cancer: New life for an old idea. J Clin Oncol 2013;31(8):1009-20. Abstract

Owonikoko TK et al. Maintenance therapy for advanced non-small cell lung cancer: Current status, controversies, and emerging consensus. Clin Cancer Res 2010;16(9):2496-504. Abstract

Paz-Ares LG et al. PARAMOUNT: Final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol 2013;31(23):2895-902. Abstract