ALK and neoplasm: From a biological view, this spectacular success is presumably related to the very low total number of missense mutations present in the exome of ALK+ tumors (tumor mutational burden, TMB), uniquely <3 mutations per Mb on average, which is lower than in all other NSCLC, indicates a higher genetic stability, and presumably facilitates the longer retainment of oncogene-addiction under targeted pharmaceuticals [19].