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In 2015, she developed progressive disease with peritoneal dissemination. Few\/absent bowel sounds and no gross features of mechanical obstruction on the imaging led to the diagnosis of paralytic ileus. Blood test revealed elevated C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">EGFR<\/jats:styled-content> mutation analysis revealed <jats:styled-content style=\"fixed-case\">S768I<\/jats:styled-content> point mutation in <jats:styled-content style=\"fixed-case\">EGFR<\/jats:styled-content> exon 20 without the <jats:styled-content style=\"fixed-case\">T790M<\/jats:styled-content> resistance mutation in pleural and peritoneal effusion cytology specimens. She received afatinib (20\u2009mg once daily) as 11th\u2010line treatment, with resolution of peritoneal carcinomatosis and <jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> normalization, confirmed by follow\u2010up computed tomography. 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