As a lung cancer specialist who deals with lung cancer and targeted drugs every day, the question we are often asked is “Doctor, we don’t want to biopsy my mother in this case, we just want to take targeted drugs, can we do it”. Because targeted drugs have the characteristics of clear targets, for patients with therapeutic targets, the efficacy is significant, while for patients without therapeutic targets, not only ineffective, but also harmful, clinical studies have shown that patients without targets and taking targeted drugs have a significantly higher risk of disease progression and death. When erlotinib and gefitinib were first introduced, lung cancer patients were treated with EGFR-TKI without biopsy and genetic testing. All clinical studies without genetic testing concluded that the efficacy of TKI was just a little better than placebo, and some findings suggested that TKI was less effective than placebo, meaning that incorrect treatment was instead harmful to patients. It was not until recent years that it was discovered that only patients with sensitive mutations could benefit from TKI treatment. 70% of patients with mutations had significant tumor shrinkage, more than 90% had disease control, longer lives, and relief of symptoms brought on by the tumor. In contrast, patients with wild type (no sensitive mutation) cannot benefit from TKI treatment, but rather are harmful. Wrong treatment delays the treatment, and adverse effects also affect the quality of life and aggravate the disease pain. Patients are invited to calculate a cost, now the TKI class of targeted drugs, there are complimentary drug program in China, Hunan Province immediately into the major medical insurance. Take TKI non-reimbursable provinces as an example, patients have to pay out of pocket, but there is a drug grant program, usually after 4~5 months of use, for patients with disease control charity grant. The cost per month before the drug gift ranges from about $11,000 to $18,000. Imagine if you took a TKI blindly without genetic testing, then you would have to spend at least $20,000 to $30,000 to know if the TKI is effective, but if you are wild type, then you would have to spend about $30,000 before you know that the drug is ineffective and you have delayed valuable treatment time, is this not a bit too much? And how much does it cost and how much time does it take to get a test done? about 7 days and costs $4000-10,000. You will understand the difference between the lesser and the more important. Convenient testing can precisely guide the medication and avoid patients without mutations from receiving harmful treatment. Wrong treatment is harmful, delaying not only money, but also the time to receive the right treatment and shortening patients’ lives. What’s more, cancer precision diagnosis has entered the era of NGS and liquid biopsy, and one-time parallel multi-target testing and free DNA testing have matured and can moreover help target detection. We strongly urge that no drug efficacy-related sensitive mutation testing, never! Targeted therapy should never be started blindly!