Melosky BSheffield B.STsou M.-HGagne S.EIonescu (Naus) D.NCHIH-HSIN YANG2020-05-262020-05-2620172468-2942https://www.scopus.com/inward/record.uri?eid=2-s2.0-85034084053&doi=10.1016%2fj.ctarc.2017.02.005&partnerID=40&md5=fdf6bfec776b7f057d868bb5a3138107https://scholars.lib.ntu.edu.tw/handle/123456789/494959Erlotinib 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. ? 2017 Elsevier LtdAfatinib; EGFR mutation; Erlotinib; Gefitinib; Non-small cell lung cancer; NSCLC; TKI, Case study; Tyrosine kinase inhibitor[SDGs]SDG3afatinib; carboplatin; docetaxel; epidermal growth factor receptor; erlotinib; gefitinib; pemetrexed; vinorelbine tartrate; adenocarcinoma; adjuvant therapy; Article; bronchus biopsy; carcinomatosis; diarrhea; drug substitution; drug withdrawal; dyspnea; fluorescence in situ hybridization; gene deletion; gene frequency; human; human tissue; immunohistochemistry; lung biopsy; lymphadenopathy; metastasis; multiple cycle treatment; mutation; mutational analysis; non small cell lung cancer; oral blister; pericardial effusion; physical examination; positron emission tomography-computed tomography; primary health care; priority journal; rash; respiratory system; stomatitis; Streptococcus; supraclavicular lymph node; thorax radiographyjournal article10.1016/j.ctarc.2017.02.0052-s2.0-85034084053