ALK and non-small cell lung carcinoma: In the ALEX trial, patients with metastatic NSCLC with ALK rearrangements treated with alectinib had a 5-year survival rate of 62%, and alectinib was approved by the FDA as first-line therapy in 2017.3 By contrast, median overall survival for patients with NSCLC who receive chemoimmunotherapy, the standard of care when targetable variants are not discovered, is 22 months.4