Baseline → treatment → follow-up
Treatment checks across the course
Relative stages, not equally spaced dates. Agree who books each check, reviews results and gives advice if a check is missed.
| Check | Before starting | First treatment | During treatment | Phase / dose review | After treatment |
|---|---|---|---|---|---|
| Bloods and symptoms | Blood count, kidney/liver, glucose, thyroid and viral checks; renal estimate | Folate and B12 in place before pemetrexed | Blood count, kidney/liver and glucose each cycle; thyroid every 3–6 weeks | After up to four cycles: carboplatin ends; continue maintenance checks | Folic acid for 21 days after last pemetrexed; remain alert to delayed immune symptoms |
| Treatment review | Confirm exact cancer setting and biomarkers | Explain expected benefit and how it will be assessed | Report new symptoms between visits | Review response, tolerability and active medicines | Agree the next treatment or surveillance plan |
| Vitamins and steroids | Folic acid lead-in and B12 in preceding week | One reconciled steroid prescription | Daily folate; B12 every three cycles while pemetrexed continues | Keep vitamins and rash prophylaxis in maintenance; review antiemetics | Folate continues for 21 days after final pemetrexed |
| Platinum effects | Baseline nerve/hearing and renal assessment | Check kidney function and carboplatin prescription | Nerve/hearing review before each platinum cycle | No carboplatin in maintenance; follow any persisting effects | Follow unresolved kidney, hearing or nerve effects |
The whole treatment journey
Pembrolizumab + pemetrexed + carboplatin: treatment and checks
First-line metastatic non-squamous NSCLC without EGFR or ALK alterations
Induction: all three medicines on Day 1 every 21 days for up to four cycles. Maintenance: carboplatin stops; pembrolizumab and pemetrexed may continue every 21 days while appropriate.
Read from left to right. Columns show stages, not equal lengths of time. This is a general plan: no dates or personal information are needed. Your team confirms which steps apply and arranges appointments.
On a small screen, swipe the map sideways. The checks below give the same timing in words.
| Care / check | Before starting | First treatment | During treatment | Phase / dose review | After treatment |
|---|---|---|---|---|---|
| TreatmentNCCP 00568 | Confirm exact indication and planned course | Start the source-specific schedule | Continue the active phase as prescribed | Confirm hold, restart, maintenance or completion | Agree follow-up and next decision |
| Bloods and symptomsNCCP 00568 | Blood count, kidney/liver, glucose, thyroid and viral checks; renal estimate | Folate and B12 in place before pemetrexed | Blood count, kidney/liver and glucose each cycle; thyroid every 3–6 weeks | After up to four cycles: carboplatin ends; continue maintenance checks | Folic acid for 21 days after last pemetrexed; remain alert to delayed immune symptoms |
| Treatment reviewNCCP 00568 | Confirm exact cancer setting and biomarkers | Explain expected benefit and how it will be assessed | Report new symptoms between visits | Review response, tolerability and active medicines | Agree the next treatment or surveillance plan |
| Vitamins and steroidsNCCP 00568 | Folic acid lead-in and B12 in preceding week | One reconciled steroid prescription | Daily folate; B12 every three cycles while pemetrexed continues | Keep vitamins and rash prophylaxis in maintenance; review antiemetics | Folate continues for 21 days after final pemetrexed |
| Platinum effectsNCCP 00568 | Baseline nerve/hearing and renal assessment | Check kidney function and carboplatin prescription | Nerve/hearing review before each platinum cycle | No carboplatin in maintenance; follow any persisting effects | Follow unresolved kidney, hearing or nerve effects |
What each check is for
1Before startingBefore first dose
Confirm suitability and baseline safety
Ask / act: Confirm results, prescriptions and responsible teams.
Sources: NCCP 00568
2Whole-course and completion reviewAt phase change or completion
Some checks and support continue after a drug stops
Ask / act: Provide the ongoing monitoring and urgent-contact plan.
Sources: NCCP 00568
At the next review, ask
- Which treatment phase am I in, and what happens next?
- Which test is expected next, who arranges it, and who explains the result?
- Who should I contact if an expected appointment has not arrived?
This map does not show whether a test has been ordered, booked or completed. Do not wait for a scheduled test if you develop new symptoms.