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This article reports two cases of bladder ALK fusion-positive PMP: a 16-year-old male achieved partial remission (PR) postoperatively with lorlatinib but experienced memory decline and mood disturbances, which resolved after dose reduction; a 34-year-old female showed significant tumor shrinkage (PR) without severe adverse reactions. The study confirms the marked efficacy of ALK inhibitors in ALK-positive PMP, but highlights the need to monitor neurotoxicity in adolescent patients. Through analysis of the FN1 (Fibronectin 1)-ALK fusion mechanism and literature review, this study emphasizes the importance of pathological differentiation, individualized treatment, and dynamic cognitive monitoring, providing insights for precision therapy in rare diseases.<\/jats:p>","DOI":"10.1093\/oncolo\/oyaf389","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:11:09Z","timestamp":1763644269000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics of the ALK fusion-positive bladder PMP and efficacy of lorlatinib: a two-case report and literature review"],"prefix":"10.1093","volume":"30","author":[{"given":"Meng","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Naval Medical University , Shanghai 200433,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyang","family":"Ju","sequence":"additional","affiliation":[{"name":"Shanghai Cancer Center and Shanghai Medical College, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Cancer Center and Shanghai Medical College, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology, School of Basic Medical Science, Naval Medical University , Shanghai 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