What would you recommend as first line treatment in stage IV EGFR L858R mutated lung adenocarcinoma that has a co-existing MET fusion?

Interesting case- amivantamab has activity against MET fusion cases and with FDA-approval in combination with lazertinib as 1L therapy based on MARIPOSA data (regardless of co-mutation status), this would be precision medicine approach as 1L option that should not incur payer-related issues.

Another option is combination of osimertinib and selective MET TKI (e.g. tepotinib, savolitinib, capmatinib) which is also precision medicine approach with reduced dermatologic side effects caused by amivanta...