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Carboplatin + pemetrexed + Keytruda: what to expect
Used for: Lung cancer
Cliff notes
Drugs in it: Carboplatin, Pemetrexed (Alimta), Keytruda.
Typical schedule: Usually every 3 weeks for 4 cycles, then pemetrexed and Keytruda continue as maintenance. You'll take folic acid and get vitamin B12 shots to make pemetrexed safer.
What to expect: You can get chemo side effects (tiredness, nausea, low blood counts) plus immune side effects from Keytruda. Report diarrhea, cough or rash early.
Your exact schedule and number of cycles are set by your oncologist and may differ from what's described here.
Side effects to know
- Appetite and taste changes
- Diarrhea
- Fatigue (extreme tiredness)
- Hair loss from chemo
- Low blood counts and infection risk (neutropenia)
- Mouth sores (mucositis)
- Nausea and vomiting
- Skin rash and skin changes
Call your care team now if you have:
- Fever of 100.4°F (38°C) or higher, or chills (possible infection when blood counts are low)
- Vomiting or diarrhea that won't stop, or you can't keep fluids down
- Unusual bleeding or bruising
- Shortness of breath or chest pain
- Signs of an allergic reaction during or after an infusion: trouble breathing, swelling of the face or throat, hives
Call 911 for trouble breathing, chest pain or signs of stroke.
▶ Watch
Watch: Introduction to Immune Checkpoint Inhibitor (ICI) Immunotherapy Side Effects (Princess Margaret Cancer Centre)
Watch: How to Prepare for Your First Infusion Treatment (Chemotherapy, Immunotherapy or Targeted Therapy) (Fred Hutch Patient Education)
Videos open on YouTube and are made by the channels named. We don't host them.
❓ Questions to ask your doctor
- What is the goal of this treatment for me?
- How will we know if it's working?
- Which side effects should I call about right away, and what number do I call after hours?
- Which medicines, vitamins or supplements should I avoid?
- Will this affect my ability to work, drive or care for my family?
- What will this cost me, and who can help me with coverage?
- How many cycles will I get, and what happens after?
Help paying
See each drug page for programs, or the independent foundations. Infused chemo is usually covered by Medicare Part B; see Medicare and your cancer drugs.
- PAN Foundation: Copays and coinsurance, including for people with Medicare, when a disease fund is open.
- HealthWell Foundation: Grants for copays, deductibles and premiums when a fund is open.
- CancerCare Co-Payment Assistance Foundation: Help with treatment copays for insured people under income limits.
- Good Days: Copay help and some travel costs.
- NeedyMeds: Free database of assistance programs, open to anyone.
Common questions
What is maintenance therapy?
After the first cycles, some drugs continue to help keep the cancer under control.
Written by the Cancer Side Effects Guide team from FDA labels and leading cancer centers. Not medical advice. · Last updated: October 15, 2026 · How we write