{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:00:27Z","timestamp":1785387627190,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"14","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172865"],"award-info":[{"award-number":["82172865"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2023LZL002"],"award-info":[{"award-number":["ZR2023LZL002"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2024MH007"],"award-info":[{"award-number":["ZR2024MH007"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","award":["ZR2021LZL009"],"award-info":[{"award-number":["ZR2021LZL009"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Anaplastic lymphoma kinase (ALK) rearrangements are rare in lung squamous cell carcinoma (LSCC), with the clinical efficacy of ALK tyrosine kinase inhibitors (TKIs) in patients harboring uncommon ALK fusions remaining poorly characterized. We report here the first identification of a novel\n                    <jats:italic>MTHFD1L\u2010ALK<\/jats:italic>\n                    fusion in a 63\u2010year\u2010old male with a heavy smoking history diagnosed with stage IIIC LSCC. The patient initially received induction therapy with the ALK TKI iruplinalkib, achieving a best response of stable disease (SD). Although subsequent chemoradiotherapy yielded a partial response (PR), disease progression occurred after four cycles of maintenance iruplinalkib, with a progression\u2010free survival (PFS) of 8.28\u2009months. Subsequent lorlatinib provided limited benefit, with disease progression at 5.3\u2009months following treatment self\u2010discontinuation. Retrospective immunohistochemical staining of ALK (D5F3) was negative despite the positive genomic finding. This case demonstrates limited clinical benefit from ALK inhibitors in LSCC with this novel fusion, expands the known mutational spectrum in non\u2010small cell lung cancer (NSCLC), and underscores the critical importance of confirming novel fusions at the protein expression level through multimodal testing.\n                  <\/jats:p>","DOI":"10.1111\/1759-7714.70348","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:47:56Z","timestamp":1784530076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Importance of Multimodal Testing for Novel\n                    <scp>ALK<\/scp>\n                    Fusions: A Case of\n                    <i>MTHFD1L\u2010ALK<\/i>\n                    Positive Lung Squamous Cell Carcinoma With Negative\n                    <scp>IHC<\/scp>"],"prefix":"10.1111","volume":"17","author":[{"given":"Huiwen","family":"Yang","sequence":"first","affiliation":[{"name":"Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan Shandong China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuqiao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan Shandong China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaohui","family":"Pang","sequence":"additional","affiliation":[{"name":"Geneseeq Research Institute Nanjing Geneseeq Technology Inc.  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinming","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9159-5197","authenticated-orcid":false,"given":"Linlin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University, Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12943\u2010018\u20100810\u20104"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.Ccr\u201011\u20102370"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2016.01.011"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1541\u20107786.Mcr\u201018\u20100171"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.10.156"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010023\u201002738\u20105"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.08.1335"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature05945"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2017.181"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29100618"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70348","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1759-7714.70348","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:36:47Z","timestamp":1785386207000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.70348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":10,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/1759-7714.70348"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.70348","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"value":"1759-7706","type":"print"},{"value":"1759-7714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70348"}}