A 55-year-old male underwent thoracoscopic-assisted small-incision radical resection of lung cancer in October 11, 2017 after diagnosis of lung adenocarcinoma...His CSF genetic testing results in May 2020 showed that mutations were EGFR p.L858R, TP53 p.R273C and ERBB2 p.S442L...his treatment was switched to dacomitinib (30mg po qd), olaparib (100mg po bid), anlotinib (8mg po d1-14,q3w), pemetrexed (500mg/m2, q3w), and temozolomide (200mg/m2 d1-5, q4w). The patient’s condition was stable after adjusting the treatment plan. His level of CEA was stable (Figure 3B), and his brain MRI showed no progression of the brain metastasis.