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How would you treat a metastatic lung adenocarcinoma with MET exon 14 skip mutation on ctDNA, negative tissue NGS and PD-L1 of >50%?

The NCCN guidelines regard MET exon 14 skip mutation as an emerging biomarker but no formal recommendation to start crizotinib. If high PD-L1 and unclear if this driver mutation decreases IO effectiveness, what upfront treatment would you recommend?
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How would you treat upfront a stage IV Lung ADC with MET exon 14 skipping mutation and PD-L1>50%?

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1 Answer
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Michigan Medical School
Answered on

I would treat this patient with single-agent pembrolizumab. If they had rapidly progressing disease with worsening symptoms or if they were a never smoker, I would favor carboplatin/pemetrexed/pembrolizumab in order to optimize rapidity of response. These recommendations are based on the results of ...

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