A 67-year-old Caucasian female patient...lymph nodes demonstrated adenocarcinoma...she was diagnosed with likely Stage IV NSCLC...After the first cycle of chemotherapy, the patient's tissue genomic testing resulted in EML4-ALK fusion, NFKBIA amplification, and NKX2-1 amplification. Given the ALK fusion result, her regimen was switched to crizotinib...PET-CT 2 months after initiation of crizotinib demonstrated a very good partial response to therapy...Her total PFS after starting crizotinib, including time off therapy after CARC development, was 36.9 months.