e19107 Background: In this study, the efficacy and safety of pemetrexed chemotherapy was evaluated retrospectively in patients who were non-responders to or who have demonstrated progression after the first and/or second line treatments in local advanced and metastatic NSCLC. Methods: 175 patients (139 males, 36 females) were assessed in years 2008 – 2012. Patients were given pemetrexed 500 mg/m2, and the ones receiving combined treatment were given pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 once in every 21 days. Supplementary steroid and vitamin treatment were administered to all patients. Age, gender, performance status (PS), stage, single agent or combined administration of treatment, progression-free survival (PFS) and overall (OS) were investigated. Patients were assessed in terms of treatment efficacy and toxicity. Results: Median follow-up period was 6 months (1 - 25), and median age was 55 years (28 - 83). In 82% of patients, PS was 0 – 1. 73% of patients were at stage 4. 71% of the patients received single agent pemetrexed, and 14% received platinum - pemetrexed combination treatment. 93% of patients received pemetrexed treatment as second line. Median 3 cycles of treatment (1 – 12) were administered. In side effect assessment, while side effects (grade 1 – 4) were observed in 62% of the patients, the most frequently observed side effects were anemia (18%) and nausea-vomiting (15%). Febrile neutropenia was detected in 6 patients (3.4%).In assessment of the response, the disease control ratio was 50% (21% partial response, 29% stable disease). 1- and OS rates were respectively 14% and 41%. Median OS was 10 months (SE:1, 95% CI: 7-12) and median PFS was 3 months (SE:1, 95% CI: 2-4). In multivariate analysis, PS of 0 – 1 and response to treatment were found as factors with prognostic significance (p=0.047, p=0.014, respectively). Conclusions: It is observed that chemotherapy regimen containing pemetrexed in NSCLC treatment is a treatment approach, which provides an efficient disease control with a manageable side effect profile, in patients especially with good performance status and with no platinum resistance, who can receive treatment in combination form.