About 3% of people diagnosed with non-small-cell lung cancer (NSCLC) have a mutation in the ALK gene. Ten years ago, the best treatment for people with this form of the cancer — who are likely to be young, to have never smoked and to be diagnosed at a very late stage of disease — was chemotherapy. But the treatment halted tumour growth for only about six months. Nature Outlook: Lung cancer Over the past decade, several generations of drugs known as tyrosine kinase inhibitors (TKIs) have emerged to better combat this mutation. These TKIs bind to ALK proteins and slow or stop cancer cells’ growth. In 2024, the US Food and Drug Administration (FDA) approved the newest of these TKIs — lorlatinib. The drug has been shown to stop the spread, or metastasis, of cancers with ALK mutations for at least five years. “We want to get to more than five years, but it’s a big, big jump forward from where we were,” says Julia Rotow, a thoracic oncologist at the Dana-Farber Cancer Institute in Boston, Massachusetts.…