Regarding second-generation ALK inhibitors, in a real-world surveillance study of alectinib in Japan, grade 1 neutropenia was reported in 50/1221 patients (4.1%), grade 2 neutropenia events in 41/1221 patients (3.4%), and grade ≥ 3 neutropenia events in 14/1221 patients (1.1%). The gene discussed is ALK; the disease is Decreased total neutrophil count.