Wenjing Yang ¹ Lin Shi ¹ Hao Wang ¹ Ying Li ¹ Xingyu Ji ¹ Hongjin Li ² Guowang Yang ^1,3* Weiru Xu ^1*

• ¹ Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, Beijing Municipality, China
• ² Beijing University of Chinese Medicine, Beijing, Beijing Municipality, China
• ³ Capital Medical University, Beijing, China

Lung cancer patient co-harboring EGFR Ex19del mutation and MET de-novo amplification is extremely uncommon. Thus, the optimal therapeutic strategies, treatment related complications and prognosis for such patients remain unclear. Herein, we describe a case of patient co-harboring EGFR Ex19del mutation and MET de-novo amplification who appeared targeted (almonertinib)-induced interstitial lung disease (ILD). And propose: patients with EGFR Ex19del mutation and MET de-novo amplification may benefit more from dual-targeted therapy than pemetrexed and carboplatin chemotherapy along with bevacizumab. However， dual-targeted therapy may increase the risk of ILD，so it is important to be alert to targeted-induced ILD，and unexplained fever may be an early warning signal for targeted-induced ILD, especially almonertinib-induced ILD. Timely intervention is needed to avoid greater harm when ILD occurs，and when ILD is effectively controlled, seize the opportunity to rechallenge the dual-targeted therapy may contribute to a better prognosis. In addition，the patients with targeted-induced ILD in the past need more rigorous monitoring and follow-up in the process of rechallenging the targeted drug therapy.