...we describe the case of a long response to ICIs treatment in a complex metastatic NSCLC with co-occuring EGFR germline and KRAS somatic mutations, high PD-L1 score and a smoking history....Our patient is a 61-year-old woman with a smoking history and a poorly differentiated NSCLC...new generation sequencing (NGS) panel analysis identified activating G13D KRAS, E17K AKT1 mutations with 11% of allelic frequency (AF) both and V843I EGFR mutation at 49% of AF....the patient received front-line pembrolizumab immunotherapy as the PD-L1 was expressed by 50% of cancer cells, with sustained partial response on all tumor sites...