How would you manage a patient with Stage IV Non-small Cell Lung Cancer with concomitant atypical EGFR mutation (such as G719D) and atypical ROS1 fusion?  

Short answer: I would start with afatinib or osimertinib. Tumors with rare EGFR sensitizing mutations, such as G719X, are responsive to EGFR TKIs, though they appear to have somewhat lower RR and duration of response than tumors with common mutations. Afatinib is the only agent FDA-approved for the...