Reintroduction of alectinib led to marked clinical improvement and a partial radiographic response in intracranial lesions.<h4>Conclusion</h4>This case suggests the aggressive nature of ALK-positive NSCLC and its high propensity for CNS metastasis, raising the possibility that personalized durations of adjuvant therapy guided by molecular biomarkers may be beneficial. This evidence concerns the gene ALK and non-small cell lung carcinoma.