An 80-year-old woman, smoker, with COPD and reduced lung capacity, in PS 2, was diagnosed with T3bN1M0 NSCLC...new cfDNA analysis showed acquired activating ALK p.R1275Q mutation in the ALK-TK-domain….Thus, Alectinib in reduced dose was initiated while continuing Osimertinib in reduced dose, due to the patient’s fragile status. The treatment was well tolerated with no adverse events and improved quality of life. Three subsequent CT-scans of chest/abdomen showed stable disease...