• 121 patients: Largest retrospective analysis of pemetrexed-based chemotherapy in ALK-positive and negative advanced NSCLC
• No difference in PFS between patients with ALK-positive and ALK-negative disease when treated with nonplatinum/pemetrexed combinations or single-agent pemetrexed
• When treated with 1^st-line platinum/pemetrexed, PFS for never/light smokers may be prolonged, regardless of ALK status

This study provides further evidence that pemetrexed may be particularly useful for patients with ALK translocations — for example, after disease progression on crizotinib. Currently we have no biopharmacologic explanation for why tumors with ALK rearrangements might preferentially respond to a specific chemotherapy, but because pemetrexed is already frequently used for advanced adenocarcinomas, it seems reasonable to turn to this agent after targeted therapies have been exhausted.