Is Targeted Therapy First Line in Metastatic Disease?

As time goes on, we're not going to be able to do randomized trials. We're just going to have to make individualized decisions. I remain optimistic that there are a population of patients with early stage disease that will be cured from targeted therapies. In the case of ALK inhibitors, there's a trial called ELENA, which compares lectinib to chemotherapy and should report in the next year or so.