The findings of a phase III trial in patients with advanced-stage ALK-rearranged non-small-cell lung cancer (NSCLC) reveal the superior efficacy of the ALK inhibitor ceritinib compared with that of platinum-based chemotherapy, in the first-line setting. Patients received four cycles of either ceritinib or cisplatin/carboplatin plus pemetrexed, resulting in a significant improvement in the median progression-free survival duration in patients receiving ceritinib (16.6 months versus 8.1 months). However, these improvements come at a price: diarrhoea, nausea and vomiting were all more common adverse events in patients receiving ceritinib compared with those receiving carboplatin or cisplatin. These data indicate that ceritinib provides a more effective but more toxic alternative to platinum-based chemotherapy for patients with ALK-rearranged NSCLC.