Abstract :Elderly advanced lung adenocarcinoma patients, especially those who failed first-line chemotherapy and EGFR-TKIs, can hardly receive conventional chemotherapy. A 71-year-old woman suffering from such situation with lung adenocarcinoma of stage IV received a total of 62 times weekly low dose pemetrexed therapy (200mg, qw) intermittently and resulted in dramatically tumor response. It is well tolerated. Weekly low dose pemetrexed might be suitable for EGFR-TKIs resistant elderly advanced lung adenocarcinoma patients.