Similarly, ALK-rearranged (most commonly EML4-ALK) adenocarcinomas have been shown, albeit primarily in case reports and small series, to undergo transformation to SCLC or large-cell neuroendocrine carcinoma (LCNEC) after ALK-TKI treatment [68,70,72,73,74,75,76,77,78,79]. This evidence concerns the gene EML4 and large cell neuroendocrine carcinoma.