These findings may help to explain the longer progression-free survival observed with alectinib vs crizotinib in the global phase III ALEX study in patients with previously untreated ALK-positive NSCLC (Peters et al, 2017) and in the Japanese phase III J-ALEX study in the ALK inhibitor-naive setting (Hida et al, 2017). The gene discussed is ALK; the disease is non-small cell lung carcinoma.