June 2017 A 61-year-old Caucasian woman presented with persistent cough and shortness of breath Patient history: Never smoked Mild hypertension, controlled on diuretic No major cardiovascular disease or diabetes Worked at local jazz club until symptoms forced her to resign Physical exam and imaging: No palpable masses CT reveals multiple tumors in right lung and brain metastases ECOG PS: 1 Biopsy and mutation analysis: Adenocarcinoma EGFRexon 19 deletion No ALK rearrangement Started treatment with afatinib 40 mg once daily Developed diarrhea that necessitated dose interruption Recovered and resumed treatment at 30 mg once daily March 2018 Patient remains on afatinib, with no apparent progression