The specific genetic alterations, including epidermal growth factor receptor (EGFR) gene mutation (30–40% of Asians and 10–20% of Caucasians), echinoderm microtubule associated protein like 4(EML4)-anaplastic lymphoma kinase (ALK) gene fusions (up to 7%), ROS proto-oncogene receptor tyrosine kinase 1 (ROS1) gene rearrangements (1.7%), BRAF V600E gene mutation (2%), and Programmed death-ligand 1 (PD-L1) status, are examined in patients with metastatic diseases in order to choose an adequate ICI [5,6]. This evidence concerns the gene EML4 and metastatic neoplasm.