The TORCH trial

Non-small cell lung cancer (NSCLC) remains a major cause of cancer-related death worldwide (1). Unfortunately the majority of patients are diagnosed with advanced disease where the treatment intent is palliative. The mainstay of treatment, until recently, has been platinum based doublet chemotherapy which improves symptoms and prolongs survival compared to best supportive care (2). Increased interest in the molecular pathways which drive cancer growth has led to the development of targeted agents such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) erlotinib and gefitinib which are both approved for use in first-line for advanced NSCLC harbouring an EGFR activating mutation and as secondor third-line treatment (erlotinib) for advanced NSCLC, independently of the EGFR mutational status.