How would you treat metastatic NSCLC in a non-smoker with bone biopsy showing adenocarcinoma of lung origin but inadequate tissue for mutational panel or PD-L1?

Molecular studies and PDL1 have become standard for patients with advanced/metastatic lung adenocarcinoma. We feel particularly strongly about doing this (molecular studies) in the never smoker, however all adenocarcinomas (and selected squamous cancers) should have this done. Cytology specimens (du...

However, unfortunately, the only FDA approved plasma test is the Roche test for EGFR mutations. This has a reasonable sensitivity for EGFR mutations by about 85% in patients who were untreated but were able to have the tissue biopsy. In a patient with insufficient tissue, the yield may be lower, giv...