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? 



Answer from: Medical Oncologist at Academic Institution
Comments
Medical Oncologist at South Denver Cancer Specialists
If the PDL1 was low and the patient symptomatic or...
Medical Oncologist at Central Cancer Care
We don't use single agent pembrolizumab frontline ...
Medical Oncologist at University of Michigan Medical School
See point #3 in my original answer. EGFR, ALK, and...
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