The breakpoint identified in our case with baseline tumor specimen (DCTN1-E19:ALK-E20) mirrors that described in NSCLC, implying that the shorter progression-free survival observed in GI malignancies does not merely depend on structural differences in the fusion itself but may be comprehensively affected by patient-related tumor microenvironment or co-occurring genomic events, such as CDK6 amplification and ATM mutation. Here, ATM is linked to neoplasm.