Introduction: Erlotinib is an approved treatment for NSCLC locally advanced or with metastases, after failure of initial chemotherapy. The authors present a NSCLC clinical case of great clinical and imaging improvement, with no drug-induced toxicity observed, after treatment with erlotinib.

Case Presentation: A 76-year-old woman, never-smoker, had been diagnosed for lung adenocarcinoma, through thoracoscopy, after presenting a large-volume pleural effusion. At the time of diagnosis it was inoperable (stage IIIB - T4 N1 M0). She was submitted to two consecutive chemotherapy treatments with carboplatin+gemcitabin and pemetrexed, respectively. Due to its failure, with lack of response, erlotinib was set as the alternative choice, with great clinical and imaging improvement after 6 months of treatment.

Conclusion: The authors recommend, even in the absence of EGFR result, the use of erlotinib when progression of the disease is seen, after initial chemotherapy, especially in lung adenocarcinoma and in never-smokers. Rev Port Pneumol 2008; XIV (Supl 3): S61-S63.

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