This patient was a 58-year-old Chinese female with no history of smoking….Pathological diagnosis indicated a typical lung adenocarcinoma (pT4N2M1b, stage IVa) (Fig. 4 A)….A NGS analysis to the FFPE specimen using a 76 cancer-related gene panel (DNA-based detection, Amoy Diagnostics, Xiamen, China) revealed a double ALK fusion: EML4-ALK ARID2-ALK (E20:A20, 0.99% abundance; and A12:A23, 1.67% abundance) (Fig. 4 C)....The patient was treated with crizotinib 250 mg twice daily in July 31th, 2014 (20 days after surgery), the disease was progressed with meningeal metastasis after 12 months’ treatment duration (Fig. 3 C)....Finally, the patient died in June 28th, 2016, having attained an overall survival of 23.9 months.