EGFR-RAD51 fusion in lung adenocarcinoma with systemic and intracranial response to osimertinib: A case report and review of the literature

•EGFR gene fusions are rare oncogenic events being increasingly detected.•In vitro and in vivo sensitivity to EGFR TKIs is proven, but no clinical data for the third-generation TKI osimertinib is available to date.•NSCLC management must include comprehensive molecular panels.•This case report illustrate sustained systemic and intracranial response to osimertinib, in a young non-smoker patient with a widely metastatic NSCLC. Comprehensive next-generation sequencing panels are leading to detection of rare gene fusion events. EFGR-RAD51 fusion is a rare oncogenic finding and clinical data for management of this condition is scarce. We report a widely metastatic non-small cell lung cancer in a never-smoker young male patient with sustained near-complete systemic and intracranial response to osimertinib, a third-generation EGFR tyrosine-kinase inhibitor (TKI). We also review the available data of other TKIs in this scenario and underscore the role of comprehensive molecular testing for NSCLC.