...we report a patient diagnosed with lung adenocarcinoma harboring EGFR 19Del/T790M/in trans-C797S mutations with co-occurring CTNNB1 alteration showing a negative response to combination therapy with first- and third-generation TKIs….he started on icotinib as first line treatment in November 2014. According to the criteria of response evaluation criteria in solid tumors (RECIST) version 1.1, best response during the first line was partial response (PR). After 18 months duration time with icotinib, progressive disease (PD) of the primary lesion in lung, as well as pleural effusion was detected with chest CT in May, 2016. Subsequently, he received combined chemotherapy (pemetrexed, cisplatin, docetaxel) with bevacizumab as second-, and third-line treatment, respectively (Figure 2). The cytotoxic administration was terminated because of the emerging lesion in mesocephalon in January, 2018.