A Window of Opportunity Study for Investigating Drug Tolerant Persister (DTP) to Preoperative Brigatinib in Resectable Non-small Cell Lung Cancer (NSCLC) Harboring ALK Fusions.

1. Clinical stage IIIb or IIIc or distant metastases (including malignant pleural effusion) identified in CT, PET-CT, brain imaging or biopsy.

2. Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening period or a positive urine pregnancy test on Day 1 before first dose of study drug.

3. Any serious medical or psychiatric illness that could, in the investigator's opinion, potentially interfere with the completion of treatment according to this protocol

4. Treatment with any investigational products within 4 weeks before the first dose of study drug

5. Had major surgery within 30 days of the first dose of brigatinib. Minor surgical procedures such as catheter placement or minimally invasive biopsies are allowed.

6. Have been diagnosed with another primary malignancy other than NSCLC, except for adequately treated nonmelanoma skin cancer or cervical cancer in situ; definitively treated nonmetastatic prostate cancer; or patients with another primary malignancy who are definitively relapse-free with at least 3 years elapsed since the diagnosis of the other primary malignancy.

7. Have symptomatic brain metastasis (parenchymal or leptomeningeal). Patients with asymptomatic brain metastasis or who have stable symptoms that did not require an increased dose of corticosteroids to control symptoms in the past 7 days before the first dose of brigatinib may be enrolled.

8. Have current spinal cord compression (symptomatic or asymptomatic and detected by radiographic imaging). Patients with leptomeningeal disease and without cord compression are allowed.

9. Have significant, uncontrolled, or active cardiovascular disease, specifically including, but not restricted to:

* Myocardial infarction within 6 months before the first dose of brigatinib.

* Unstable angina within 6 months before first dose of brigatinib.

* Congestive heart failure within 6 months before first dose of brigatinib.

* History of clinically significant atrial arrhythmia (including clinically significant bradyarrhythmia), as determined by the treating physician.

* Any history of clinically significant ventricular arrhythmia.

* Had a cerebrovascular accident or transient ischemic attack within 6 months before first dose of brigatinib.

10. Have uncontrolled hypertension. Patients with hypertension should be under treatment on study entry to control blood pressure.

11. Have a history or the presence at baseline of pulmonary interstitial disease, drug-related pneumonitis, or radiation pneumonitis.

12. Have an ongoing or active infection, including, but not limited to, the requirement for intravenous antibiotics.

13. Have a known history of HIV infection. Testing is not required in the absence of history.

14. Have malabsorption syndrome or other GI illness that could affect oral absorption of brigatinib.

15. Have a known or suspected hypersensitivity to brigatinib or its excipients.

16. Are pregnant, planning a pregnancy, or breastfeeding.

17. Have any condition or illness that, in the opinion of the investigator, would compromise patient safety or interfere with the evaluation of brigatinib.

18. Received systemic treatment with strong cytochrome P-450 (CYP)3A inhibitors, strong CYP3A inducers, or moderate CYP3A inducers within 14 days before enrollment.

What this study is about