ALK and gallbladder cancer: Furthermore, targeted therapy, such as anaplastic lymphoma kinase (ALK) inhibitors, induces a complex network of secretory signals, promoting the survival of cancer cells sensitive to the drug.[2] A study based on Surveillance, Epidemiology, and End Results database showed that lung cancer patients with a duration >120 months had an increased risk of secondary primary gallbladder cancer.[3] Owing to tumor heterogeneity, there may be multiple mechanisms of treatment resistance and the development of multiple primary tumors in the same patient.