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Anaplastic lymphoma kinase (  ALK  ) fusions have been recognized as a therapeutic target in non‐small cell lung cancer ( NSCLC ). However, molecular signatures and clinical characteristics of the Chinese population with   ALK  ‐rearranged  NSCLC  are not well elucidated. In the present study, we carried out targeted next‐generation sequencing on tissue and plasma ct DNA  samples in 1688 patients with  NSCLC . Overall,   ALK   fusions were detected in 70 patients (4.1%), and the frequencies of   ALK   fusions detected in tissue and plasma samples were 5.1% and 3.3%, respectively. Additionally, the prevalence of breakpoint locations for   EML 4‐ ALK   fusions in ct DNA  was significantly correlated with that in tumor tissues ( R  2  = .91,  P  = .045). According to age, the incidence rates of   ALK   fusions among young (age &lt;45 years), middle‐aged (between 45 and 70 years) and elderly (&gt;70 years) patients were significantly different ( P  &lt; .001). In 70   ALK  ‐rearranged cases, coexistence of epidermal growth factor receptor (  EGFR  ) alterations and   ALK   fusions was detected in 12 cases (17.1%) and   EGFR   mutations tended to coexist with non‐  EML 4‐ ALK   rearrangements. Notably, novel   ALK   fusion partners, including   TRIM 66 ,   SWAP 70 ,   WNK 3 ,   ERC 1 ,   TCF 12  and   FBN 1  were identified in the present study. Among   EML 4 ‐  ALK   fusion variants, patients with variant V1 were younger than patients with variant V3 ( P  = .023), and   TP 53  mutations were more frequently concurrent with variant V3 compared with variant V1 ( P  = .009). In conclusion, these findings provide new insights into the molecular‐clinical profiles of patients with   ALK  ‐rearranged  NSCLC  that may improve the treatment strategy of this population.

Molecular and clinical analysis of Chinese patients with anaplastic lymphoma kinase ( ALK )‐rearranged non‐small cell lung cancer