Our data suggest that for patients with grade II–III or III lung adenocarcinoma, especially those with a history of smoking and high tumor burden with significant symptoms, waiting for the result of EGFR mutational analysis before initiating first-line therapy may not be the best decision because the incidence of positive EGFR mutation is extremely low at 1.8% (one out of 56 cases) for these patients. The gene discussed is EGFR; the disease is lung adenocarcinoma.