The patient had been diagnosed with advanced lung adenocarcinoma with EML4-ALK fusion 1 year previously….Next-generation sequencing confirmed that samples from the primary lung lesion and gum metastasis all harbored EML4-ALK fusion (V3) and I1171T (Figure 2)...treatment was switched to brigatinib (180 mg once daily with a 7-day lead-in at 90 mg once daily) for this patient, and a response was obtained for at least 10 months including gingival metastasis (Figure 3(a) for 2 months brigatinib) and lung nodules (Figure 3(b) for 2 months brigatinib, Figure 3(c) for 6 months brigatinib).