Pemetrexed

Aetna covers pemetrexed for second‑line locally advanced/metastatic/relapsed transitional cell bladder cancer; persistent, recurrent, or metastatic cervical cancer; specified recurrent epithelial ovarian/fallopian tube/primary peritoneal cancers as single‑agent therapy; pleural/peritoneal mesothelioma when used alone or with cisplatin/carboplatin or with bevacizumab or durvalumab plus a platinum; and non‑squamous non‑small cell lung cancer (including leptomeningeal metastases). It is excluded for squamous NSCLC and is considered experimental/investigational (not covered) for many other cancers (e.g., AML, biliary, breast, colorectal, hepatocellular, pancreatic, renal, small cell lung, head/neck squamous), pemetrexed+gefitinib for medulloblastoma, and MTHFR polymorphism testing to predict pemetrexed effectiveness/toxicity.

"Hematologic/laboratory thresholds before starting a new cycle: ANC must be ≥ 1500 cells/mm3 and platelet count must be ≥ 100,000 cells/mm3"