NSCLC Stage 4 Adeno Second Line Treatment - 1269453

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NSCLC Stage 4 Adeno Second Line Treatment - 1269453


Is the combination of Alimta and Avastin approved for a second line treatment in the United States? I cannot find a clear answer. I've read reports that Alimta and Avastin are a common second line treatment for non-squamous NSCLC but our doctor is saying it has not been approved yet.

Thank you,


Dr West
That combination is actually

That combination is actually not approved for second line. It's far more commonly used as a continuation maintenance therapy approach for patients who were previously on carboplatin/Alimta (pemetrexed)/Avastin (bevacizumab), then carboplatin was dropped after 4-6 cycles of first line therapy with the three drug regimen.

Because Avastin is so expensive, it tends to be approved more readily in the first line setting, where it has been better tested, than in second line or later.

Good luck.

-Dr. West

Dr. Howard (Jack) West
Associate Clinical Professor
Medical Oncology
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education