We investigated the VAF of resistance mutations in CTCs from 14 ALK-rearranged patients progressing on crizotinib...The ALKR1275Q mutation (VAF, 8%) described as activating in patients with neuroblastoma was found in a CTC specimen of P32 but not in the tumor biopsy, as well as nine “off-target” mutations including TP53 (VAF range, 3%–25%; ref. 50).