Turn on the TORCH before treat your patients: a lesson from a first line study in advanced NSCLC

The first line treatment of (EGFR unselected) stage IV non small cell lung cancer (NSCLC), in Western countries, is driven by the disease (histology) and by the patient [age and performance status (PS)]. Infact non-squamous NSCLC benefits more of pemetrexed based-chemotherapy and older or poor PS are prescribed more often monochemotherapy rather than platinum-based doublet. On the contrary, in patients with known, positive, EGFR mutations status, the first line choice is an anti-EGFR tyrosine kinase inhibitor (TKI) as erlotinib or gefitinib according also to data of EURTACH study (1).