ALK tyrosine kinase inhibitors (TKIs) were found to have statistical significant progression-free survival (PFS) prolongation compared with platinum chemotherapy in several phase 3 studies.1, 2, 3 Second-generation ALK TKIs, alectinib and brigatinib, were found to have significantly better activity and safety profile compared with crizotinib, a first-generation ALK TKI, in treatment naive advanced NSCLC patients with ALK rearrangement.4, 5, 6 Despite such improvements in clinical outcomes in ALK-rearranged NSCLC, almost all patients acquired resistance to ALK TKIs. This evidence concerns the gene ALK and non-small cell lung carcinoma.