ALK and non-small cell lung carcinoma: Crizotinib (Xalkori, PF-02341066), the first-generation ALK inhibitor, has become the standard first-line therapy for ALK-positive non-small cell lung cancer allowing survivals up to 5 years.[13,14] According to a study, 6.7 to 18.2% of patients acquire resistance within 12 months.[15] The presence of drug resistance in this patient was not surprising given that the patient was receiving the medication for the last 36 months.