Interestingly, a study described a 69-year-old never-smoking male NSCLC patient with EGFR/ALK wild-type adenocarcinoma, who developed sequential histological transformations—adenocarcinoma with sarcomatoid change, squamous cell carcinoma with sarcomatoid change, and pure squamous cell carcinoma—during chemotherapy, radiotherapy, and pembrolizumab treatment. Here, ALK is linked to adenocarcinoma.