The TOPICAL study should be more topical!

The TOPICAL study - a prospective randomized study of first line therapy with erlotinib versus placebo in patients with advanced NSCLC, who were unfit for (standard) chemotherapy, was recently published by Lee et al. (Lancet Oncology, October 16. 2012) (1). The study was performed in patients with PS ≥2. The best therapy for this prognostic unfavorable group of patients has for decades been discussed, and many comparative studies performed; doublet chemotherapy versus single agent chemotherapy, EGFR TKI versus chemotherapy etc. Most widely used for this group of patients is single agent chemotherapy.