Are ALK rearrangement variants promising predictive biomarker of ALK tyrosine kinase inhibitors efficacy?

We read with interest the article by Woo et al. reporting ALK tyrosine kinase inhibitors (ALK-TKIs) efficacy in 51 ALK-positive patients with known EML4-ALK rearrangement variants (v) [1]. The authors report a better 2-year progression-free survival (PFS) rate with crizotinib in the v1/v2/others group (n = 24) compared with the v3a/b group (n = 20) (76% versus 26.4%, P = 0.034). This differential efficacy of crizotinib among ALK variants is supported by in vitro experiments.

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