Similarly, in a 58-year-old female patient (#4, Table 4) with newly diagnosed NSCLC (adenocarcinoma, UICC stage IV, cT2b, cN0, cM1c) with pulmonary, bone, brain, and leptomeningeal metastasis, systemic chemotherapy was switched to in-label afatinib in addition to intrathecal methotrexate injections after activating EGFR mutations (Exon 18, p.G719C; exon 20, p.S768I) were diagnosed by liquid CSF biopsy. The gene discussed is EGFR; the disease is adenocarcinoma.