New standards of care for ALK-positive disease
The first-generation ALK inhibitor crizotinib is the current standard option for patients with newly diagnosed, advanced ALK-positive NSCLC. However, patients invariably relapse on crizotinib treatment, with the central nervous system (CNS) being one of the most common and challenging sites of relapse. The second-generation ALK inhibitor alectinib is more potent than crizotinib [1, 2] and shows clinical activity in crizotinib-resistant NSCLC [3-6]. Notably, trial data have indicated significant CNS activity. Alectinib has become a standard therapy for patients with crizotinib pre-treated ALK-positive NSCLC, but research efforts are ongoing to establish it as a first-line option.