The patient was started on alectinib, an ALK inhibitor, because of disease progression despite chemotherapy…..Her bone metastases have shown partial response as per RECIST radiographic criteria on a dose of alectinib of 450 mg twice daily alternated with 300 mg twice daily...our patient was treated with adjuvant cisplatin–etoposide doublet chemotherapy based on the LCNEC diagnosis. This was followed by subsequent treatment with alectinib for the newly developed bony metastasis, with an ongoing partial response....As the bone metastases that were confirmed as metastatic ALK‐positive LCNEC showed a partial response with alectinib, we can speculate that the LCNEC component had responded in this case.