Gefitinib, as a member of the ‘‘small molecule’’ tyrosinekinase inhibitors (TKI),16,17is a standard first-line treat-ment for NSCLC patients with EGFR mutation. Several randomized phase III trials demonstrated that gefitinib prolonged progression-free survival and improved quality of life compared with platinum-based doubletchemotherapy.4—6 However, the development of secondary resistance inevitably leads to treatment failure (in the most recent studies for up to 10—14 months).10 The most common molecular mechanisms of secondary resistance are hreonine tomethionine aminoacid change at position 790 (T790M) of the EGFR kinase domain (found in 50% of cases) and MET amplification (found in up to 20% cases).18,19 Some agents were designed to overcome the secondary resistance, such as afatinib, which is an irreversible inhibitor against all EGFR family members and T790M mutation,20hasalso demonstrated to be superior to chemotherapy in EGFR