LAUSR

Erlotinib and gefitinib are first generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI). Afatinib is a second generation pan-Her EGFR TKI. All three TKIs have demonstrated superiority to chemotherapy in the first line setting in patients harboring an EGFR mutation in the EURTAC [1], IPASS [2], LUX-LUNG 3 [3] and LUX-LUNG 6 [4] trials. This article describes the case of a patient treated at a Cancer Centre in Taiwan and at the British Columbia Cancer Agency in Canada. This patient experienced a remarkable response to a number of different systemic treatments. Despite not having a detectable EGFR mutation, he had a positive and prolonged response to all three EGFR TKIs. This case challenges current treatment paradigms for the treatment of a NSCLC patient whose tumour does not have an activating EGFR mutation.