Such an early dissemination is typical for the presence of EML4–ALK v3 (E6;A20) and/or TP53 mutations, whereas EML4–ALK v2 (E20;A20) TP53wt adenocarcinomas show a more indolent course and have a longer OS (Christopoulos et al. 2019a). This evidence concerns the gene TP53 and adenocarcinoma.