Nakagawa K, Hida T, Nokihara H, et al. - In the J-ALEX study, alectinib was compared with crizotinib in Japanese patients with advanced ALK-positive non-small-cell lung cancer (NSCLC) and was demonstrated as superior in independent review facility (IRF)-assessed progression-free survival (PFS) at the second pre-planned interim PFS analysis (data cutoff: December 3, 2015; hazard ratio 0.34, 99.7 % confidence interval [CI]: 0.17–0.71). Researchers here aimed at describing final PFS data and the second pre-planned interim analysis of overall survival (OS) and safety (data cutoff: June 30, 2018). Participants were patients aged ≥ 20 years who were ALK inhibitor-naïve and chemotherapy-naïve, or had received one prior chemotherapy regimen; participants received either alectinib 300 mg (n = 103) or crizotinib 250 mg (n = 104) twice daily. Outcomes revealed sustained improvement in IRF-assessed PFS with alectinib. In the second interim OS analysis, no conclusion regarding the superiority of alectinib to crizotinib was made. Fewer grade ≥ 3 adverse events were reported among alectinib-treated patients. In IRF-assessed PFS, alectinib continued to demonstrate superiority vs crizotinib.