Nonetheless, most ALK+ patients receiving alectinib have a life expectancy exceeding 5 years [9], especially in the absence of high-risk features such as the EML4-ALK variant 3 of TP53 mutations [29,30], so the risk of long-term complications, such as cholelithiasis due to increased serum bilirubin in most cases (58%, Figure 1e), remains unclear at present [31]. Here, ALK is linked to cholelithiasis.