...genotype disclosed an EGFR exon 19 deletion (19-Del) mutation and PTEN frameshift mutation (p.K237Cfs*17). She subsequently received two cycles of irinotecan in combination with 1 month of third-generation EGFR-TKI osimertinib. However, the tumor dramatically progressed with enlargement of liver metastases (Figure 3A). After that, her disease also failed to respond to anlotinib plus pembrolizumab and anlotinib plus Tiggio. Finally, with fast tumor progression, she died 1 month later.