Of note, lorlatinib also demonstrated outstanding clinical efficacy in this patient setting.14 Nevertheless, whether lorlatinib is an optimal option for first-line therapy is controversial since it plays an important role in salvage therapy for patients refractory to second-generation ALK inhibitors,26 as well as its uniquely unpleasant toxicity profile, such as hypertriglyceridemia, hypercholesterolemia, edema, peripheral neuropathy, and CNS toxicity.27 This evidence concerns the gene ALK and hypertriglyceridemia.