A 64-year-old Chinese woman was diagnosed with advanced lung adenocarcinoma...She was determined as having insertion mutations in exon 20 of the HER2 gene (c.2326G > TTGT) by the amplification refractory mutation system (ARMS) and HER2 gene amplification (HER2/CEP17 ratio 2.6) by fluorescence in situ hybridization (FISH)...Thereafter, she was treated with afatinib as first-line therapy, to which she responded.