ALK mutation

P2, N=13, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: Feb 2026 --> Feb 2027 | Trial primary completion date: Feb 2026 --> Feb 2027

P2, N=56, Not yet recruiting, Tianjin Medical University Cancer Institute and Hospital

P2/3, N=427, Suspended, National Cancer Institute (NCI) | Trial completion date: Dec 2027 --> Dec 2030 | Trial primary completion date: Dec 2027 --> Dec 2030

Treatment of cancer patients with selective ALK inhibitors, such as Ceritinib, causes dysgeusia. Mice receiving Ceritinib had a dramatic reduction in taste bud volume and innervation, and a significant portion of PHOX2B+ neurons died, demonstrating that ALK is critical for development and maintenance of oral sensory neurons.

As such, the BCL-2 inhibitor venetoclax further enhanced RMC-6236-mediated killing by disrupting RMC-6236 enhanced BIM:BCL-2 complexes. RMC-6236 is a clinically relevant drug that can successfully target the MAPK pathway in these cancers. This study supports expanded clinical testing of this novel therapy to this important subset of neuroblastoma.

This review summarizes the associations between genetic mutations and metastatic sites, explores underlying molecular mechanisms, and discusses mutation-based risk prediction and personalized therapeutic strategies. With multi-omics integration and further clinical research, genetic profiling may become a key tool for guiding metastasis prevention, early intervention, and treatment optimization in NSCLC.

P2, N=15, Not yet recruiting, Se-Hoon Lee

This report supports crizotinib can provide potential benefit for anaplastic lymphoma kinase/MET14 co-mutated lung adenocarcinoma patients, but sufficient cases and further research are needed to confirm and explore the possible mechanisms involved.

P2/3, N=840, Recruiting, AbbVie | Active, not recruiting --> Recruiting | N=167 --> 840

Brigatinib was initiated, and a complete radiologic response was documented within 3 months and has been sustained for over 12 months, including durable intracranial disease control. Sustained CR in I1171N-mediated alectinib resistance is rare and highlights the critical role of repeat molecular testing to guide ALK TKI sequencing.

In conclusion, ALK mutation is associated with promoted cancer immunity and can be treated as a biomarker for favorable outcomes in pan-cancer immune checkpoint blockade. These results have implications for treatment decision-making and developing immunotherapy for personalized care.

The vertebral niche constitutes a treatment-resistant microenvironment where dormant tumor cells persist, immune surveillance is impaired, and resistant clones evolve. Integrating bone-microenvironment biology with molecular profiling, liquid biopsy, and advanced imaging is essential for refining prognostic models, guiding intervention timing, and designing spine-specific clinical trials. By reframing spinal metastases as a biologically and therapeutically distinct disease entity, this review establishes a framework for developing bone-directed treatment strategies and advancing precision oncology in metastatic spine care.