ALK and lung cancer: This randomized phase 2 study of patients with LM from breast or lung cancer found proton CSI improved CNS PFS (primary endpoint) and OS compared to photon WBRT with select, focal spine RT.30 Only 21 (21%) of patients in the study had EGFR or ALK NCLSC, they were not evenly distributed, and the study did not randomize to TKI alone or photon CSI.