Background: This study compares the safety and efficacy of first-line treatments for anaplastic lymphoma kinase (ALK)-mutated non-small cell lung cancer (NSCLC).Methods: A comprehensive literature search was conducted in PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases.Abstracts related to lung cancer presented at important international conferences were also reviewed. Randomized clinical trials that qualified the inclusion criteria were subjected to Bayesian network meta-analysis and systematically reviewed. Results:The authors included a total of nine studies including 2441 patients and seven first-line treatments (ensartinib, brigatinib, crizotinib, lorlatinib, alectinib, ceritinib, and pemetrexed-based chemotherapy). Overall, lorlatinib appeared toThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Primary cardiac angiosarcoma (PCA) is a relatively rare and fatal disease with poor prognosis. It remains controversial whether its survival can be improved with additional treatment besides complete surgical excision. In this case,we presented a 52-year-old man with PCA in the right atrial who underwent a palliative resection, but suffered from metastases of the brain, lung and liver rapidly. He accepted multi-mode combination therapy including first-line chemotherapy, second-line anlotinib which was not only concurrent with brain radiotherapy but also concurrent with immunotherapy in the end. Although anlotinib combined with brain radiotherapy had a effectively control on the intracranial lesions, progression free survival was 5 months. But overall survival didn’t significantly prolonged, for he only survived for 12 months. In conclusion, the treatment for those metastatic PCA still needs further exploration.