A large clinical trial has confirmed the promise of a targeted drug therapy in advanced non-small-cell lung cancer.

The drug crizotinib, which targets an oncogenic protein encoded by the mutated ALK gene, extended progression-free survival in patients with ALK mutations by 7.7 months, compared with 3 months for chemotherapy alone. The results from the trial, which included 347 patients, are reported by Alice Shaw at Massachusetts General Hospital in Boston and her colleagues, and come just six years after the discovery of ALK fusion mutations in cancer and two years after the drug was approved for non-small-cell lung carcinoma in the United States on the basis of smaller clinical trials.

A related paper from a team also led by Shaw reports a new mechanism of resistance to crizotinib in one patient, showing that the search for effective targeted treatments must continue.

N. Engl. J. Med. 368, 2385–2394; 368, 2395–2401 (2013)