Comprehensive genomic and immune profiling of ALK fusion-positive and negative lung adenocarcinomas

ALK-positive lung adenocarcinomas are associated with a younger age at sequencing, lower tumor mutational burden, higher PD-L1 expression, and lower cancer testis antigen burden compared to ALK-wild-type, EGFR mutated, and KRAS mutated lung adenocarcinomas. Our results suggest a need for considering patients with ALK-positive lung adenocarcinomas in clinical trials involving immune checkpoint inhibitors despite their exclusion in many trials.