What is the optimal first-line treatment for advanced anaplastic lymphoma kinase-rearranged non-small cell lung cancer?

Anaplastic lymphoma kinase (ALK)-gene rearrangements work as an oncogenic driver in 3–8% of patients with non-small cell lung cancer (NSCLC) (1,2). These patients tend to be younger than those without driver mutations, and have no or little smoking history. ALK-rearranged tumors are usually adenocarcinomas, frequently with an acinar-predominant structure (3). In general, ALK rearrangements are mutually exclusive of other activating mutations such as epidermal growth factor receptor (EGFR) and KRAS mutations (2).