Kwok WC, Cheong TF, Chiang KY, et al. - Among 329 patients suffering from advanced stage non-squamous non-small cell lung carcinoma (NSCLC) who received first line pemetrexed and platinum, this retrospective single-center cohort analysis was conducted to compare the occurrence of hematological toxicity between patients who had non-evacuated third-space fluid, evacuated third-space fluid and without third-space fluid, given concern about the accumulation of pemetrexed in third space fluid that could lead to increased toxicity. According to findings, a predisposition to significant hematological toxicity was observed in the presence of non-evacuated third-space fluid in patients with advanced non-squamous NSCLC treated with pemetrexed and platinum chemotherapy. Prior to initiating pemetrexed and platinum doublet, evacuation of third-space fluid should be considered.