Targeted next-generation sequencing (NGS) of 39 cancer-associated genes [SNaPshot NGS version 1; Massachusetts General Hospital (MGH), Boston, MA] detected the presence of a G2032R (c.6094G > A) mutation in the ROS1 kinase domain10. Additionally, two single-nucleotide variants were detected in TP53: W146* (c.437G > A) and N263D (c.787A > G). The latter, TP53 N263D variant (rs72661119), has been reported in 10 of 13,894 individuals in the South Asian population and is likely a polymorphism30. The patient was treated with stereotactic body radiation therapy (SBRT) to the growing lung nodule and continued on crizotinib. Subsequent scans showed growth of an adjacent left lower lobe lung nodule, which was not biopsied, but treated with microwave ablation (Fig. 1a).