• In the treatment of locally advanced or metastatic NSCLC, the incidence of fatigue with pemetrexed monotherapy (second line) or in combination with cisplatin (first line) was comparable with the standard chemotherapy used in the control arms of the two phase 3 trials (docetaxel in second line and gemcitabine plus cisplatin in first line).1,2
• Pemetrexed administered as maintenance treatment following first-line treatment with a platinum doublet was associated with a statistically higher incidence of grade 3/4 fatigue when compared to placebo (5% vs 0.5%; p=.001).3
• Continuation maintenance with pemetrexed was associated with a significantly higher incidence of grade 3/4 fatigue when compared to placebo (5.3% vs 1.1%; p<.05 for grade 3 only). The incidence of grade 1/2 fatigue ranged from 6.7% to 14.5% for pemetrexed and 0% to 12.5% for placebo in cycles 1 through 11.4
• In the first-line treatment of metastatic NSCLC with pembrolizumab or placebo plus pemetrexed/platinum, fatigue was commonly observed and did not differ significantly for those patients in the pembrolizumab-combination arm vs those in the placebo-combination arm (40.7% vs 38.1%, respectively).5

• Lilly does not recommend a specific approach to treating cancer- and/or treatment-associated fatigue. Decision on patient treatment options should be individually-based in consultation with their physician.
• Patients with fatigue may benefit from pharmacologic and nonpharmacologic interventions. Natural and alternative remedies, as well as complementary treatments (eg, physical exercise), should also be considered.6

AE = adverse event

Lilly = Eli Lilly and Company

NSCLC = non-small cell lung cancer