In stage IV NSCLC, the 5-year survival rate with pembrolizumab is 32% in patients with high programmed death-ligand 1 (PD-L1) expression (4), while in those with anaplastic lymphoma kinase (ALK) rearrangement (5), the 5-year survival rate with alectinib is 62%. The gene discussed is ALK; the disease is non-small cell lung carcinoma.