A 60-year-old non-smoking male was referred with a 3-month history of productive cough secondary to lung adenocarcinoma...Next-generation sequencing identified an IGR (upstream HIVEP1-) ALK fusion...The patient was subsequently started on alectinib, with no obvious adverse reaction. After 1 month of therapy, the patient achieved significantly remission of the clinical symptoms and had led to an ongoing partial response (PR) lasting >33 months.