Currently, docetaxel is the standard second-line treatment for patients with non-small-cell lung cancer (NSCLC) with a good performance status, based on phase III randomised studies showing improved outcomes compared with ifosfamide, vinorelbine or best supportive care. However, in phase II studies, pemetrexed has shown clinically-relevant activity against NSCLC as initial or second-line therapy. New data presented at the 12th European Cancer Conference (ECCO) [Copenhagen, Denmark; September 2003] suggests that not only is pemetrexed similar to docetaxel in terms of clinical efficacy, it also costs less and results in fewer drug-related adverse events.1,2