Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (TKI) often loses effectiveness against non-small cell lung malignancies (NSCLCs) with ALK gene rearrangements (ALK+).19 Novel imidazo[1,2-b]pyridazine macrocyclic derivatives, e.g., I, were designed, synthesized, and tested for their biol. activities in an effort to develop ALK inhibitors that would overcome second-generation ALK-TKIs, particularly G1202R mutation and lorlatinib-resistant L1196M/G1202R double mutations.Of all target substances, compound I had most effective enzymic inhibitory activity, with IC50 values for ALKWT, ALKG1202R, and ALKL1196M/G1202R of 2.6, 6.4, and 23 nM, resp.Compound I, on other hand, reduced growth of ALK-pos. Karpas299, BaF3-EML4-ALKG1202R, and BaF3-EML4-ALKL1196M/G1202R cells with IC50 values of 38, 52, and 64 nM, resp.This was equally effective to reference drug Repotrectinib (IC50 = 40, 164, and 208 nM).The kinase selectivity profile, liver microsome stability test and in vivo pharmacokinetic properties in SD rats of compound I were further evaluated.Compound I was regarded as an effective ALK inhibitor for treatment of mutations overall.