She received palliative radiation followed by 6 cycles of pembrolizumab by her then treating oncologist owing to a programmed death-ligand 1 (22C3) expression level of 90%. Initial plasma genotyping using Guardant360 (Guardant Health Inc., Redwood City, CA) around the time of diagnosis revealed KIF5B-RET fusion (allele frequency [AF]: 0.3%) and TP53 P190T (AF: 1.8%). Subsequent tumor genotyping revealed KIF5B-RET (K15, R12; AF: 16.10%) and TP53 P190T (AF: 51.05%) through FoundationOne CDx (Foundation Medicine Inc., Cambridge, MA)...The patient did not respond to 6 cycles of single-agent pembrolizumab...