For patients with metastatic disease, the outcome largely depends on the identification of a targetable driver such as EGFR, ALK, ROS1, ERBB2, BRAF, MET and more recently KRAS, RET, NRG1 and NTRK1-2-3, as mutations or gene fusions are highly predictive of response to matched targeted therapy. The gene discussed is ROS1; the disease is metastatic neoplasm.