Over the course of 7 days, three therapies were used to reduce the volume of the patient’s secretions. Initially, azithromycin, 500 mg/d, and scopolamine, 0.6 mg IV bid, were initiated, resulting in a decrease in secretion volume by 12.5% within 24 h. Fluticasone, 250 μg inhaled bid, was added. Inhaled indomethacin was considered, but was not available at our institution. This combination resulted in a reduction in secretion volume by 75% within 48 h, to 450 mL/d, which allowed extubation. Once the patient was extubated, we commenced an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib, 250 mg/d, while his biopsy tissue specimen was analyzed for an EGFR mutation. Within 24 h, the volume of the patient’s pulmonary secretions further decreased to <100 mL/d. Other medications were discontinued, and he remained on gefitinib, with control of his bronchorrhea. His receptor status was subsequently found to be negative. He suffered clinical deterioration as a result of the disease progression and was palliated 2 months after diagnosis.