Notably, canonical activating RAS pathway mutations (HRAS, NRAS, KRAS, BRAF, RAF1, CDK4, CCND1, NF1) were significantly more frequent in relapsed ALT-positive neuroblastomas in the INFORM cohort compared to the discovery cohort (P = 0.0013, Supplementary Fig. 10, Fig. 3a), supporting a specific impact of RAS pathway mutations in relapsed ALT-positive tumors. Here, CDK4 is linked to neuroblastoma.