Retrospective study of ALK inhibitors in patients with nonlung malignancies bearing ALK alteration

ALK inhibitors are known to produce deep responses in certain cancer types; however, data on their use outside these types are scarce. A retrospective study at City of Hope Cancer Centers evaluated outcomes of these drugs for tumor types without current FDA approval. The authors collected data on patients who received ALK inhibitors from 2013 to June 2025, with exclusion of patients with NSCLC, ALCL, inflammatory myofibroblastic tumors, and patients treated in a clinical trial. A total of 19 patients were included; the most common histologies were sarcomas (26%) and papillary renal cell carcinoma (16%). Most patients (73%) had two or more metastatic sites at baseline, often harboring ALK fusions (68%). ALK inhibitors were adminstered as third-line therapy or later in 52% of patients. The median time to treatment failure with ALK inhibitor therapy was 9.1 months (95% CI 3.3-13.3), compared with 2.6 months (1.6-5.5) for the previous line. Among 15 patients with imaging, 53.3% had partial responses and 26.7% had stable disease. The median overall survival was 9.1 months (95% CI 3.3-13.3).