EGFR and non-small cell lung carcinoma: Evidence guiding optimal first-line management in this subgroup, particularly in elderly patients, remains limited.<h4>Case presentation</h4>We report a case of an elderly patient with treatment-naïve advanced non-squamous NSCLC harboring a concurrent <i>EGFR</i> exon 19 deletion and de novo <i>EGFR T790M</i> mutation.