Michael P. Link, MD, 2011–2012 President of ASCO and a pediatric oncologist himself (at Stanford University School of Medicine and the Lucile Salter Packard Children’s Hospital at Stanford), said the crizotinib study by Mosse and colleagues has far-ranging implications. “The molecular driver (ALK) is present in very different and sometimes unrelated tumor types, and thus this ALK inhibitor may work in very different cancers,” he predicted. “It may turn out to be even more effective in this form of non-Hodgkin lymphoma than it is in lung cancer.”

Furthermore, he added, “we have a glimpse at a new paradigm of understanding cancer and drug development—that it will someday not be sufficient to identify tumors by their histology or organ of origin, but will be necessary to understand the tumor’s heterogeneity and molecular drivers in order to select treatment. If you understand this, you can choose the appropriate inhibitor, and you have the prospect of seeing dramatic responses.” ■

Disclosure: Dr. Link is currently negotiating for research support from Pfizer for a follow-up study of crizotinib in tumors with genetic events in the ALK gene.