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The study was modified after randomization and treatment of 117 patients to require that all patients receive folic acid 350 mcg to 1000 mcg daily beginning 1 to 3 weeks prior to the first dose of pemetrexed and continuing until 1 to 3 weeks after the last dose, vitamin B12 1000 mcg intramuscularly 1 to 3 weeks prior to first dose of pemetrexed and every 9 weeks thereafter, and dexamethasone 4 mg orally, twice daily, for 3 days starting the day prior to each pemetrexed dose

at a dose of 500 g twice a week, 56 a dose lower than in most other trials

Avec supplment hebdomadaire, pour les personnes ne consommant pas de B12 alimentaire (vgtaliens), ainsi que pour les lacto-ovo-vgtariens ou personnes consommant trs peu de produits dorigine animale