ALK positive

P2, N=41, Recruiting, Jennifer Crombie, MD | Active, not recruiting --> Recruiting

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

We report the case of a 3-year-old boy with progressively worsening biphasic stridor, found to have an isolated ALK+ histiocytic lesion in the subglottis. This case represents the first reported instance of an isolated ALK+ histiocytic lesion of the airway managed with endoscopic debulking.

P2, N=118, Active, not recruiting, Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest | Trial completion date: Jan 2026 --> Apr 2026 | Trial primary completion date: Jan 2026 --> Apr 2026

P3, N=327, Active, not recruiting, UNICANCER | Recruiting --> Active, not recruiting

P2, N=10, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Dec 2025 --> Dec 2026

Treatment was then switched to the ALK inhibitor alectinib, and the patient again achieved a partial response. This case suggests that chemotherapy may enrich ALK fusion-positive tumour cell clones through selective pressure. These findings highlight the clinical importance of repeated genetic testing after disease progression and provide new insights for post-resistance treatment strategies.

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.

Among patients with advanced non-small cell lung cancer (NSCLC), ALK-positive disease accounts for roughly 5% of cases We conducted a systematic search of PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov for randomized controlled trials comparing first-line ALK inhibitors with crizotinib or platinum-based chemotherapy and reporting intracranial outcomes. The safety profile was comparable between second- and third-generation ALK TKIs, with alectinib reporting fewer grade ≥3 adverse events (RR 0.72, 95% CI 0.58-0.88). These findings support the use of second- and third-generation ALK TKIs, particularly lorlatinib, as preferred first-line options for patients presenting with brain metastases at diagnosis.