Patient description: The patient is a 47-year-old Asian woman complaining of persistent feelings of sadness. She lost interest in activities she used to enjoy. She states that her mood is mostly depressed for the past 3 weeks. She also lost her appetite , which led to about 5kg weight loss. She complains of loss of energy and feelings of worthlessness nearly every day. She is not using any drugs and she does not smoke. She doesn't drink alcohol. She used to exercise every day for at least 30 min. But she doesn't have enough energy to do so for the past 3 weeks. She also has some digestive issues recently. She is married and has 4 children. She is menopausal. Her husband was recently diagnosed with colon cancer and he is starting his chemotherapy. There is nothing remarkable in her past medical history and her drug history is only positive for Vit D3 1000 units daily. Her family history is negative for any psychologic problems. Her HAM-D score is 20.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Carcinoma, Non-Small-Cell Lung Pathologic or cytologic confirmed diagnosis of NSCLC 2. Recurrent, advanced or metastatic NSCLC that has progressed following one prior platinum based chemotherapy regimen (not counting adjuvant or neoadjuvant chemotherapy if completed more than 12 months prior to platinum based therapy) 3. Patients who are eligible for pemetrexed as second line chemotherapy 4. Measurable disease by one or more techniques (CT, MRI) according to 5. Patients aged 18 years or older 6. Life expectancy of at least three (3) months 7. Eastern Cooperative Oncology Group (ECOG) performance Score 0-2 8. Written informed consent that is consistent with ICH-GCP guidelines and local legislation  Treatment with an investigational drug in another clinical study within the past 28 days prior to the start of therapy or concomitantly with this study 2. Anti-cancer therapy for NSCLC (except radiotherapy for palliative reasons) within the past 28 days prior to Treatment Day 1 of Cycle 1 of this trial 3. Any persisting toxicities which are deemed to be clinically significant from the previous therapy 4. Patients who have received more than one prior chemotherapy regimen for advanced disease (not including prior adjuvant therapy). Patients may have received prior epidermal growth factor receptor tyrosine kinase inhibitors. 5. Patients who are unwilling or unable to take folic acid and vitamin B12 supplementation 6. Active brain metastases (stable for <28 days, symptomatic, or requiring concurrent steroids). Patients who have received prior whole brain irradiation and whose brain metastases are stable according to the above will not be excluded. 7. Other active malignancy diagnosed within the past 3 years (other than non melanomatous skin cancer and cervical intraepithelial neoplasia) 8. Concomitant intercurrent illnesses including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness or social situation that would limit compliance with trial requirement or which are considered relevant for the evaluation of the efficacy or safety of the trial drug 9. Patients unable or unwilling to interrupt concomitant administration of 5 days prior to, the day of and 2 days after the administration of pemetrexed, with the exception of lose dose aspirin 81mg daily 10. Patients who have received prior therapy with pemetrexed 11. Absolute neutrophil count (ANC) less than 1,500/mm3 12. Platelet count less than 100,000/mm3 13. Hemoglobin <90g/L 14. Total bilirubin >26µmol/L 15. Alanine amino transferase (ALT) and/or aspartate amino transferase (AST) less than 2.5 X ULN, except in case of known liver metastasis where maximum 5 X ULN is acceptable 16. Serum creatinine level >133µmol/L and/or creatinine clearance (measured or calculated) <45 ml/min 17. Clinically relevant QTc prolongation 18. Women and men who are sexually active and unwilling to use a medically acceptable method of contraception 19. Pregnancy or breast feeding 20. Known or suspected active alcohol or drug abuse 21. Patients unable to comply with the protocol 22. Any known hypersensitivity to the trial drugs or their excipients 23. Patients with NSCLC of confirmed Squamous histology