Would you consider ALK-directed TKI for a ALK L1198F point mutation in a patient with metastatic lung adenocarcinoma after progressing through first line chemoimmunotherapy?  

I would not because de novo ALK point mutations are rarely sensitizing in lung cancer. This specific mutation has been described in anaplastic thyroid cancer. From this question, it is not clear if this patient (1) had an underlying ALK rearrangement (which is the alteration we predict would be acti...