Survival outcomes for patients diagnosed with lung cancer have improved substantially in recent years. This progress has been driven, in part, by the recognition that lung cancer is not a single disease, but a collection of biologically and molecularly distinct subtypes. Comprehensive genomic profiling enables the identification of actionable alterations and the selection of targeted therapies that can produce deeper, more durable responses with improved tolerability. ALK-positive lung cancer provides a compelling example of how successive generations of targeted therapies have transformed outcomes for a previously poor-prognosis disease. National programs such as ASPiRATION and ASPiRATION-2 Liquid have sought to broaden access to genomic testing through tumour tissue and circulating tumour DNA, helping embed precision medicine into routine care across Australia. The next challenge is to understand and eliminate persisting disease that ultimately drives treatment resistance and relapse. By integrating increasingly precise therapies, longitudinal molecular monitoring and strategies targeting residual disease, we aim to achieve long-term survival and ultimately transform advanced lung cancer into a chronic—and potentially even curable disease.