• Concurrent cisplatin (cis)/pemetrexed (pem) and radiation therapy (RT) followed by consolidation pem was not superior to a commonly used chemoradiation therapy regimen (OS HR = 0.98) in this 598-patient study.
• Cis/pem in combination with RT followed by consolidation pem demonstrated an acceptable safety profile.

The current standard chemotherapy partner for radiation therapy in locally advanced NSCLC is a platinum agent with either etoposide or a taxane, mainly paclitaxel. At ASCO we saw data from a large Phase III trial using either pem or etoposide in combination with cis in nonsquamous lung cancers. Both arms received postchemoradiation therapy consolidation (patients assigned to cis/pem received 4 cycles of pem and those assigned to cis/etoposide received 2 cycles of one of several consolidation options). Overall the 2 approaches were similar in terms of OS, but a trend toward a higher ORR was observed in the cis/pem group. These patients also had fewer Grade 3/4 adverse events, particularly neutropenia. The bottom line, as pointed out by Dr Spigel, is that the study was designed to detect superior survival with cis/pem and was closed prematurely because it failed to meet that endpoint, and although he does not currently use this regimen, he does not find fault with physicians who choose it because of better tolerability.