Immunotherapy and tyrosine kinase inhibitors (TKIs) have increased the therapeutic opportunities.[1] Anaplastic lymphoma kinase (ALK) rearrangement is present in approximately 5% of metastatic NSCLC.[2] ALK positive patients benefit from TKIs, such as alectinib, a specific second-generation ALK TKI. This evidence concerns the gene ALK and non-small cell lung carcinoma.