First line erlotinib for NSCLC patients not selected by EGFR mutation: keep carrying the TORCH or time to let the flame die?

The BR.21 study evaluated the efficacy of erlotinib in an unselected population after progression on one or two prior chemotherapy regimens (1). The study demonstrated an improvement in median overall survival from 4.7 to 6.7 months, demonstrating the activity of erlotinib. Subsequently, the IPASS trial compared first line therapy with gefitinib or carboplatin-paclitaxel in the first line (2).