My brother diagnosed Mar 2013 NSCLC IV ALK+. Cis/ Alimta then Alimta maintainance. Xalkori. Ceritinib,. WBR October 2017 because of LMD, straight after Blood clot in lungs and started blood thinner and still on Oxygen, From last two months on Alectinib but not effective and now disease progress to liver and Pancreas. He got tumour in bike duct and bilirubin shoot up, started taking Steroids and bilirubin reduce but LFt shoot up to 600 and doctors are not doing ERCP because they are suggesting he is on 6 litre of oxygen and oxygen must drop to already 2 which seems impossible, normally what to expect and any way out? Any example of patient who has successfully have ERCP while on Oxygen or some one has used Nivolumab which has good effect on liver mets but heard not good for ALK+? Any example or suggestions to over come this situation?