Objective  To examine the efficacy and safety of pemetrexed plus apatinib for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC) in elderly patients.

  Methods  Between January 2016 and June 2017, 38 elderly patients with advanced non-squamous NSCLC from Qingdao Municipal Hospital were examined. All patients received first- or second-line therapy. The inclusion criteria were an age of ≥ 65 years, physical status score of 0-2, and expected survival time of >3 months. Eighteen patients were assigned to the test group, and the remaining 20 patients were assigned to the control group. The patients in the test group were treated with pemetrexed plus apatinib, pemetrexed 500 mg/m² on day 1 and apatinib 250 mg/d on days 1-21. The control group received pemetrexed in a 21-day cycle until the disease progressed or intolerable adverse reactions developed. The study was reviewed and approved by the medical ethics committee of Qingdao Municipal Hospital.

  Results  The disease control rates in the test and control groups were 72.2% and 35%, respectively, with a statistically significant difference (χ²=5.265, P=0.022). The median progressionfree survival time (PFS) in the test and control groups were 5.7 months95% confidence interval (CI):2.8-8.6 and 3.1 months (95% CI:2.7-3.5), with a statistically significant difference (χ²=4.01, P=0.045). The difference in the incidence of hand-foot syndrome and hypertension between the two groups was statistically significant (P=0.007 and P=0.016, respectively), with side effects of 1 or 2 degree in most cases, which was acceptable.

  Conclusions  Pemetrexed plus apatinib has a definite curative effect on advanced NSCLC, with controllable adverse reactions.