Over the past decade, the identification of actionable oncogenic driver alterations has revolutionised the treatment landscape of advanced non-small cell lung cancer (NSCLC). Among these, rearrangements involving the anaplastic lymphoma kinase (ALK) gene, or ALK fusions, have emerged as a distinct molecular subset, primarily affecting younger patients with little or no smoking history. The development of ALK tyrosine kinase inhibitors (TKIs) has led to remarkable improvements in clinical outcomes, particularly compared to conventional chemotherapy. More recently, the role of ALK inhibition has also expanded into the adjuvant setting for patients with resectable disease. This article provides an up-to-date overview of the evolving therapeutic landscape for ALK-positive NSCLC.
