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Patients were randomized (2:1) to one of the following treatment arms: Pemetrexed 500 mg/m2, pembrolizumab 200 mg, and investigators choice of cisplatin 75 mg/m2 or carboplatin AUC 5 mg/mL/min intravenously on Day 1 of each 21-day cycle for 4 cycles followed by pemetrexed 500 mg/m2 and pembrolizumab 200 mg intravenously every 3 weeks

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Healthcare professionals should maintain a low threshold for B12 testing in symptomatic patients, particularly those with risk factors, and should not delay treatment when neurological involvement is suspected

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