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August 4, 2017. Did you read yesterday’s story and wonder: what the heck is alectinib? You’re not alone. Data supporting this drug is hot off the press as established by this summer’s landmark NEJM pub. A drug you probably do recognize is crizotinib, the previous standard of care in the setting of advanced non-small cell lung cancer (NSCLC) harboring the ALK-oncogene. It’s had great results...but as with all targeted therapies, bypass mechanisms remain available to rogue tumor cells. Enter alectinib, a second generation ALK-inhibitor designed to tackle several of the most common pathways of resistance to it’s predecessor crizotinib. When put head-to-head against crizotinib for ALK-rearranged NSCLC, alectinib resulted in a 20% absolute increase in progression free survival at one year and a 33% reduction in new or worsening brain mets. We know it’s never easy to be replaced by a younger version, crizotinib, but you’ll always be the patriarch of ALK-inhibition in our eyes.