On the contrary, driver mutations in NSCLC like EGFR mutation and ALK, ROS1, RET, and NTRK rearrangements are more prevalent in non-smokers, and most of these molecular alterations are associated with low TMB level, which may partly explain the lower efficacy of immune checkpoint inhibitors in never-smoker patients with advanced NSCLC 27, 28. This evidence concerns the gene ROS1 and non-small cell lung carcinoma.