ALK and large cell neuroendocrine carcinoma: To the best of our knowledge, there were a limited number of prior case reports detailing ALK-positive LCNEC patients, most of whom were treated with sequential ALK inhibitors and and only started using lorlatinib once they became TKI-resistant experienced disease progression (Leblanc et al., 2021; Akhoundova et al., 2022; Wiedemann et al., 2022).