ALK and non-small cell lung carcinoma: The recent emergence of targeted therapies to programmed cell death ligand 1 (PD-L1) has dramatically improved the survival of advanced NSCLC patients through targeting immune checkpoints to enhance tumor-directed immunity.7 Tumors with specific mutations may respond less well to immunotherapy drugs, and FDA-approved drugs that target specific mutations in EGFR and ALK may be more effective.8 These are now under investigation for patients with NSCLC BM but it is not clear whether selecting agents based on the mutation profile of the primary tumor is appropriate.