Anaplastic lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) co-alterations in adenocarcinomas are rare and no therapeutic consensus is reached. The potentially negative prognostic effects of programmed death-ligand 1 (PD-L1) expression on tyrosine kinase inhibitor (TKIs) efficacy further complicates the treatment options for patients with ALK/EGFR co-alterations and PD-L1 over-expression. We describe a case of advanced lung adenocarcinoma, harboring concurrent ALK/EGFR mutations and extremely high PD-L1 expression, that achieved sustained remission by the first-line treatment strategy of antiangiogenic therapy combined with chemotherapy. It is our firm conviction that the use anti-angiogenics should not have fallen out of favor in this era of targeted therapy and checkpoint inhibitors.

间变性淋巴瘤激酶 (ALK)/表皮生长因子受体 (EGFR) 在腺癌中的共同改变是罕见的，并且没有达成治疗共识。程序性死亡配体 1 (PD-L1) 表达对酪氨酸激酶抑制剂 (TKI) 疗效的潜在负面预后影响使 ALK/EGFR 共同改变和 PD-L1 过度表达患者的治疗选择更加复杂。我们描述了一例晚期肺腺癌，同时伴有 ALK/EGFR 突变和极高的 PD-L1 表达，通过抗血管生成治疗联合化疗的一线治疗策略实现了持续缓解。我们坚信，在这个靶向治疗和检查点抑制剂的时代，使用抗血管生成药物不应该失宠。