The most significant change in the pattern of management has been the use of TKIs to prevent the onset of brain metastases in patients with NSCLC with activating mutations in either the epidermal growth factor receptor (EGFR) gene, in case of anaplastic lymphoma kinase (ALK) gene rearrangement, or in Her-2/neu overexpressing breast cancer. The gene discussed is ALK; the disease is non-small cell lung carcinoma.