Do you hold or avoid pemetrexed in patients with NSCLC and pleural effusions?   

I do not. Given pemetrexed's relationship to methotrexate as an antifolate, the question has come up of whether the same precautions taken with methotrexate regarding effusions/third space fluid are necessary for pemetrexed. Thankfully, this does not appear to be the case, as several studies (here i...