How would you approach first-line treatment in metastatic NSCLC for a patient with ALK-EML4 V3a/b variant and MSI-high status?

It's a good question. I would first confirm the MSI-high status using tissue-based testing. I would recommend a pathology re-review in light of these molecular findings, and consider the possibility that this could be metastatic colorectal cancer. While EML4-ALK fusions are most common in NSCLC, the...