Currently, tumor tissue is analyzed mainly with next-generation sequencing (NGS) for activating pathogenic variants or rearranged fusion oncogenes in EGFR, ALK, BRAF, MET (exon 14 skipping), KRAS, ROS1, RET and NTRK. However, only approximately 50% of patients have a targetable pathogenic DNA variant [1], and for patients without access to targeted first line treatment including patients with pathogenic KRAS variants, chemotherapy, immune checkpoint blockade (ICB), combined chemotherapy and ICB or combined ICB are the main treatment options [2]. Here, ALK is linked to neoplasm.