ALK and adenocarcinoma: Most patients had adenocarcinomas (n = 83, 76 %) and 27 (25 %) were found to have an oncogenic driver alteration (EGFR: n = 29, ALK: n = 4); 80 (73 %) presented with BOM disease at initial diagnosis (de novo) and 29 (27 %) were diagnosed with BOM as recurrent disease following initial diagnosis with non-Stage IV disease (Table 1).