Concurrent presence of 2 or more ALK-fusion forms is rare.[2,3] Echinoderm microtubule-associated protein 4 (EML4) is the most frequently fusion partner of ALK fusion.[4] Additionally, brain metastasis occurs in approximately 23% to 31% of patients with ALK-fusion NSCLC and is associated with a poor prognosis.[5,6] ALK tyrosine kinase inhibitors (TKIs) exhibit therapeutic effects in patients with ALK fusion and potentially leading to significant improvements in the survival and prognosis of those with ALK-positive (ALK+) NSCLC. Here, EML4 is linked to non-small cell lung carcinoma.