Tricia et al explored the expression of Programmed Cell Death-Ligand 1 (PD-L1) in 28 IMT cases, unveiling that PD-L1 expression occurred in 80% of recurrent and metastatic tumors and 88% of ALK-negative tumors, providing a rationale for further investigations on the utility of checkpoint blockade therapy in the treatment of refractory IMT.[28]. Here, ALK is linked to metastatic neoplasm.