occurred in separate cellular clones. The level of the C797S mutation is expected to be similar to or lower than the level of the T790M mutation if both mutations are present in the same cells, and it would show either concomitant increase or decrease in response to the combination therapy. The levels of each EGFR mutation measured by digital droplet polymerase chain reaction from a series of plasma samples indicated that the T790M and C797S mutations were likely present in different tumor cells, a finding that as we suggested in our article, may be due to multiple clones with individual mutations and resultant differences in tyrosine kinase sensitivity. 3 In the blood collected before the combination therapy, the levels of the T790M and C797S mutations were detected at mutant allele frequencies of 2.8% and 4.5%, respectively. This indicates that the overall load of C797S-positive tumor was higher than that of T790M-positive tumor before the combination therapy. The observed clinical improvement without reduction in T790M or exon 19 deletion also supports this hypothesis of clonal heterogeneity rather than the mutation being present in the same cells. Definitive proof, however, would require single-cell analysis, which is not possible for this patient.